Medicine and Health Sciences Commons^™

Occupational Therapy’S Role In Addressing Wellness In Underserved Communities, Kimberlyna Chheang, Amy Lyons-Brown, Anna Saavedra

Summer 2024 OTD Capstone Symposium

This capstone project addresses sociodemographic disparities in community wellness and health services in Kern County, CA, focusing on underserved communities facing trauma and systemic inequalities. In collaboration with the Community Action Partnership of Kern (CAPK) and their East Kern Family Resource Center (EKFRC), it aims to lay the foundation for community-based, tailored interventions using occupational therapy (OT) to enhance community well-being and promote access to critical services to support wellbeing.

Policy Review And Recommendation: Full Practice Authority For Nurse Practitioners In The Southwestern United States, Sara J. Rowe

Student Scholarly Projects

This policy analysis investigates the benefits of full practice authority (FPA) for Nurse Practitioners (NPs) in the Southwestern United States, using Arizona as an FPA model and California and Tennessee as comparison states. The PICO question that directed the project is: for NPs practicing as advanced practice nurse practitioners within the Southwestern United States region (P), does a comprehensive policy recommendation for FPA for NP-led clinics in the secondary education space (I) compared to existing variable approaches within the region (C) improve access to care and direct or indirect patient outcomes as endorsed by the literature (O)? A comprehensive literature …

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

Impact Of A Provider Flagging System On Increasing Ezetimibe Utilization In High-Cardiac Risk Adults, Janessa Creado

Student Scholarly Projects

Practice Problem: Cardiovascular disease continues to be the leading cause of mortality globally. Often, healthcare providers fail to follow evidence-based guidelines in their practice.

PICOT: In high cardiac-risk, adult patients with low-density lipoprotein cholesterol (LDL-C) levels greater than 70 milligram/deciliter (mg/dl) despite being on a maximum tolerated dose of statin (P), what was the effect of a provider flagging system to initiate ezetimibe (I) compared to standard care (C) on increasing the utilization of ezetimibe according to the 2018 American Heart Association (AHA) guidelines (O) within 8 weeks (T)?

Evidence: An extensive evidence literature review …

Point Of Care Testing: Best Practice Toolkit For Improving Access To Point Of Care Testing In Mobile Medicine, Michaela Gist

Student Scholarly Projects

Practice Problem: Healthcare for persons experiencing homelessness (PEH) is a complex issue. Chronic and communicable diseases are disproportionately represented within this population. Healthcare spending is 2.5 times more costly in comparison to those who have not experienced homelessness. Although mobile health clinics aim to reduce the concerns with access to care, they do not eliminate barriers if the appropriate tests are not immediately available.

PICO: In the homeless population treated in mobile medicine (P), what is the effect of point of care testing (I) on turnaround time (O) compared with outside laboratory testing (C)?

Evidence: Critical analysis of the literature …

Patient Navigational Tool Increase Resource Use In A Latino Population, Kimberly Burrus

Student Scholarly Projects

Practice Problem: The practice problem is a patient navigation tool in a mobile health clinic for the Latino population to help improve utilization of resources within Daviess County, Indiana, and improve overall health literacy and health of those populations?

PICOT: The PICOT question that guided this project was: In a mobile health clinic serving Latino populations (P), does a navigation tool (I) compared to current practices (C) improve utilization of services (O) within a 12-week timeframe (T)?

Evidence: The evidence that guided this project showed patients with limited English proficiency, immigrant families have a disparity of health literacy, and an …

The Use Of Alcohol Impregnated Port Catheters For Decreasing Central Line Infections In Acute Care, Shana M. Coons

Student Scholarly Projects

Practice Problem: Lack of proper sterile protocol for central lines was noted as a problem in the acute care units, causing CLASBI rates to be higher than the national average at the hospital in question.

PICOT: In hospitalized acute care adult patients 18 years of age and older with central lines, how does the use of alcohol impregnated port protectors (AIPPs) compared to current central line sanitation practices affect central-line associated infections (CLASBI) within 10 weeks?

Evidence: The literature evidence suggests that Alcohol Impregnated Port Protectors (AIPPs) decrease CLASBI rates and provide better outcomes for acute care patients with central …

Evidence Based Practices To Guide Practitioners On Providing Racially Informed Care (Ric): A Scoping Review, Veronica Ajose, Angela Labrie Blackwell, Charae Mcconnell

Summer 2023 Virtual OTD Capstone Symposium

All forms of racism impact the health, well-being, safety, and occupations of Black, Indigenous, and People of Color (BIPOC). There is a gap in Occupational Therapy (OT) curricula and literature on how practitioners should address the issue of racism. This presentation presents the background, problem, purpose, methods, results, and implications for occupational therapy practice for a scoping review that sought to review sought to identify and synthesize interventions that align with Racially Informed Care (RIC).

Hypertension: Care Management Program And Medication Adherence, Courtney Montgomery

Student Scholarly Projects

Practice Problem: Medication adherence is a major concern in healthcare as it is a contributing factor to uncontrolled hypertension and resistant hypertension. Uncontrolled hypertension can lead to strokes, heart attacks, kidney failure, and even death.

PICOT: The PICOT question that guided this project was in Medicare Advantage members with hypertension located in Kansas, who were admitted to the hospital or emergency room identified by stratification (P), does care management utilization using hypertension clinical guidelines (I), compared to the stand-alone hypertension clinical practice guideline (C), improve medication adherence (O) over 10 weeks (T)?

Evidence: Hypertension is one of the leading preventable …

Hypertension Education To Enhance Health Literacy, Kylee Westrip

Student Scholarly Projects

Practice Problem: The health of patients suffers greatly when their health literacy is not addressed through evidence-based education material.

PICOT: The PICOT question that guided this project was, in adult patients with hypertension (P), how does evidence-based education material (I) compared to the current state of verbal instructions provided (C) affect health literacy rates based on the high blood pressure health literacy scale (O) within 12-weeks (T)?

Evidence: The literature evidence revealed three strong themes, which included information on who is most at risk for low health literacy levels, education delivery methods, and specific education to be used.

Intervention: …

Supporting Caregivers Of The Aging Adult: A Program Evaluation, Tanya O'Brien

Student Scholarly Projects

There is an ever-increasing burden on caregivers of individuals with cognitive illness as a result of the increasing number of older adults with dementia and Alzheimer's disease. Currently, St. John's County Florida offers three programs designed to provide support for caregivers of individuals with cognitive illness. This project evaluated the three programs as part of a program evaluation to determine the efficacy of program selection for sustainability. Utilizing the Center for Disease Control's (CDC) Program Evaluation Framework (PEF), a detailed and thorough evaluation review of the Power Tools for Caregivers, Savvy Caregiver, and an original three-model program developed by the …

Filipino Physical Therapists’ Practice And Perspectives On Non-Treatment Physical Activity For Older Adults, Frances Rom M. Lunar, Attilah Mae B. Alog, Alexa Ds Tanchuling, Kristen Mari Andal, Beatrice Camille Chan, Daniel C. Chua, Claire Beatrice Martinez, Ma. Anna Carmina D. Orlino, Jem Bettina G. Tan, Koji A. Katakura Jr., Marvin Louie S. Ignacio

Philippine Journal of Physical Therapy

Introduction:

Studies have already investigated the practice of physical therapists (PTs) in promoting non-treatment physical activity (NTPA). However, these were done in the context of mostly western settings or were not specific to older adult practice. It is still unclear if a similar level of practice and perspectives on NTPA promotion exists in a setting where physical therapy is more associated with rehabilitation than health promotion, such as in the Philippines. Therefore, this study aimed to describe Filipino PTs' knowledge of WHO physical activity (PA) guidelines and their use of behavioral change techniques (BCTs) and theories when promoting PA in …

History Of Falls, Mild Cognitive Impairment, And The Presence Of Home Environmental Hazards Among Community-Dwelling Older Persons In District V, Manila, Marilou J. Raval, Donald S. Lipardo

Philippine Journal of Physical Therapy

Introduction: It is important to investigate factors that may increase the fall risk in the geriatric population. This study aimed to determine the relationship between: 1) mild cognitive impairments (MCI) and history of falls; 2) home environmental hazards (HEH) and history of falls; and 3) MCI and HEHs among older adults.

Methods: Community-dwelling older persons of District V, Manila were random sampled to participate in this cross-sectional correlational study. The Home Falls and Accidents Screening Tool for Health Professionals (HOMEFAST-HP) and Fall History Questionnaire were used to collect information on the presence of HEH and history of falls, respectively. Chi-Square …

Increasing The Prescribing Of Pre-Exposure Prophylaxis (Prep) With A Pre-Exposure Prophylaxis Screening Tool, Cassey Hall

Student Scholarly Projects

Practice Problem: Human Immunodeficiency Virus (HIV) is one of the leading pandemics in the world. In 2019, 38 million people were living with HIV around the world. Of those, roughly 87% were aware of their HIV status.

PICOT: In patients with high risk for HIV, how does implementing a pre-exposure (PrEP) screening tool compared to randomly screening for pre-exposure prophylaxis (PrEP) affect the prescribing of pre-exposure prophylaxis (PrEP) within eight weeks?

Evidence: In 2015, the World Health Organization (WHO) recommended PrEP for the prevention of HIV in high-risk individuals. The patients include men who have sex with …

Evidence-Based Best Practice Toolkit For Social Determinants Of Health: A Program Evaluation Review, Bryleigh Berry

Student Scholarly Projects

Despite an increase in healthcare expenditure, racial and ethnic disparities remain a substantial concern among adult primary care patients in the United States. This is largely due to the focus on medical intervention and disregard for the underlying factors that contribute significantly to health outcomes such as economic stability, educational access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. The PICOT question that guided this program evaluation review project is: In adult clients seeking care at a primary care clinic (P), how does a SDOH toolkit based on the CDC framework (I) compared …

The Role Of Occupation Therapy In Homeless Transition-Aged Youth Programs, Cortney Kirby Yap, Susan Macdermott

Spring 2022 Virtual OTD Capstone Symposium

The purpose of this project was to evaluate current programming with staff at Urban Street Angels (USA) and explore the role of occupational therapy (OT) with youth experiencing homelessness or are at risk of homelessness in San Diego, California. The project informed the development of proposals aimed to enhance programming and OT services already in place at the USA La Mesa site for the staff and the youth enrolled in services through the USA organization and the Housing Our Youth (HOY) collaborative program.

An Ipa Analysis Examining Transportation, Community Engagement, And Healthcare Access Of Elderly Adults In A Rural Border Community, Madison Rowlinson, Angela Blackwell, Karen Aranha

Spring 2021 Virtual OTD Capstone Symposium

Introduction: There is a lack of understanding about the accessibility needs of elderly borderland residents, and the barriers that they face when they try to maintain their health and well-being.

Objectives: To analyze transportation and community engagement in a rural community on the US-Mexico border. To analyze the findings of transportation and community engagement in a rural community on the US-Mexico border.

Methodology: A triangulated study using the Place Standard Assessment, Semi-Structured Interviews, and a walking survey with the theoretical framework of the Person, Occupation, Environment, Performance (N=3). Data analysis consisted of comparing means generated by the PSA on 14 …

Implementation Of An Evidence-Based Practice Discharge Medication Protocol For Heart Failure Patients To Reduce 30-Day Readmissions, Dawn Onstott

Student Scholarly Projects

Practice Problem: An estimated 6.5 million American adults ≥20 years of age have heart failure (HF) and worldwide 1 to 2% of the total healthcare budget is spent on HF. To improve outcomes and streamline the treatment of HF patients, The American Heart Association (AHA) joined with the American College of Cardiology (ACC) and created the Get With The Guidelines Program (GWTG).

PICOT: The PICOT question that guided this project was in adult HF patients admitted to the cardiovascular unit under the care of the hospitalist service, does implementing an evidence-based practice (EBP) discharge medication protocol for physician use …

Decreasing Readmissions In Medically Complex Children, Colleen Bartlett

Student Scholarly Projects

Practice Problem: There was a report of an existing practice problem of increased 30-day readmission rates in medically complex children at an outpatient clinic within an extensive hospital system. Hospital readmissions can cause clinical, social, and financial burdens to the patients and their families and thus reflected a need for interventions to reduce readmissions.

PICOT: The PICOT question that guided this change project: In medically complex pediatric patients ages 0-17, what is the effect of a discharge intervention bundle in reducing all-cause 30-day hospital readmissions compared to current practice within an 8-week timeframe?

Evidence: The literature revealed 18 …

Physical Therapists’ Perceptions Of Barriers To The Use Of Evidence-Based Fall Prevention Intervention With Individuals Of 65 Years Of Age Or Older, Charles Agbonghae

Student Dissertations

Falls are a problem in the elderly population. Evidence-based fall prevention programs are available but physical therapists do not always utilize them. The literature identifies a number of barriers to clinician’s use of evidence-based interventions in general but there is limited knowledge of barriers to the use of evidence-based interventions in the clinical practice area of fall prevention. The purpose of this study was to identify barriers perceived by physical therapists to the use of evidence-based fall prevention interventions with individuals of 65 years of age or older. The study utilized an on-line survey of physical therapists licensed in Texas. …

Loneliness And Drinking In An Hiv Positive Population, Erica Kiernan, Krishna Chhabria

Public Health Collection

Background: Loneliness is a common outcome in the HIV+ community due to the stigma associated with it leading to social isolation. Studies show HIV+ individuals who experience significant loneliness do engage in risky sexual behaviors. Alcohol use also has adverse consequences in this population, interfering with antiretroviral medication adherence thus an increased likelihood of further risky sexual behaviors.

Hypothesis: HIV+ individuals who experience an increase in loneliness will have an increase in hazardous drinking behaviors.

Methods: 100 patients from an HIV treatment clinic in Jacksonville, Florida were administered the AUDIT scale to measure drinking habits and UCLA loneliness scale. …

Neighborhood Factors That Contribute To Alcohol Use And Loneliness In Hiv Positive Patients, Erica Kiernan, Eugene Dunne, Barbara Curbow, William Latimer

Public Health Collection

Background: Neighborhood factors contribute to substance abuse and increased health risk behavior. Alcohol use has adverse consequences as it may interfere with antiretroviral medication adherence. In addition, studies have shown that those who are HIV positive have decreased social network size, limited social support, and social isolation as well as decreased treatment adherence. It is hypothesized that participants with high neighborhood density of alcohol outlets combined with increased feelings of loneliness will be more likely to drink.

Methods: Participants included 85 patients from an HIV treatment clinic in Jacksonville. Interviewer-administered measures included the Alcohol Use Disorders Identification Test …