Medicine and Health Sciences Commons^™

Improving Nurse Proficiency: Breastfeeding And The Opioid-Dependent Mother And Infant Diagnosed With Neonatal Abstinence Syndrome (Nas), Lauren Mountanos

Master's Projects and Capstones

Management of the opioid-dependent mother-infant dyad is complex. Evidence suggests breastfeeding may decrease the severity of NAS symptoms, delay its onset, and decrease the need for pharmacologic treatment (Macmullen et al., 2014). Therefore, education of nursing staff on the benefits of breastfeeding for opioid-dependent dyads will enable them to safely recommend breastfeeding for long-term health (Pritham, 2013). The Clinical Nurse Leader (CNL) project, “Improving Nurse Proficiency: Breastfeeding and the Opioid-Dependent Mother and Infant Diagnosed with Neonatal Abstinence Syndrome (NAS)” aims to globally increase the number of infants diagnosed with NAS discharged on breast milk by 10% by June 30, 2018. …

The Evaluation Of The Effectiveness Of Community-Based Mobile Meal Programs For Low-Income Families, Nicholas Vesom

Master's Projects and Capstones

Food disparity is a continuously prevalent issue in the United States despite the presence of programs, such as the Women, Infants, and Children (WIC) program and the National School Lunch Program (NSLP), to fill gaps in reaching those who are financially inhibited and do not have a sustainable source of nutritionally balanced food. A primary part of the issue that arises is that these types of programs have restrictions on age or only operate during the school year. To assess this issue, the Mountain View Whisman School District (MVWSD), in conjunction with the Stanford University Pediatrics Advocacy Program (SUPAP), initiated …

Ready, Set, Action: Potential Breakthrough Therapy For Treatment-Resistant Depression, Alvin Garlejo

Master's Projects and Capstones

Major depressive disorder is a psychiatric illness that is associated with a variety of debilitating symptoms such as persistent sadness, lack of interest and motivation, lassitude, pessimistic thoughts, and in severe cases, suicidal ideation and behavior. Current psychological and pharmacological treatments have been demonstrated efficacious; however, an ever-growing number of individuals frequently report minimal to no improvement with these treatments; and in some cases, a worsening of symptoms. This inadequacy to treatment is commonly known as treatment-resistant depression. At Kadima Neuropsychiatry Institute, Dr. Feifel treats individuals with treatment-resistant depression with advanced treatments such as TMS and ketamine. During my fieldwork …

A Novel Model Of “Remedy And Elimination Of Tuberculosis”, Akanksha Mishra

Master's Theses

Tuberculosis (TB), is one of the top ten causes of death worldwide. TB is commonly linked to poverty and creates poverty as it is the single largest cause of death in the 15-49-year-old age group in South-East Asia (WHO, 2017). It is also linked to the HIV population, and its leading cause of death. TB is effected by socio-economic factors, cultural factors, and health policy. My goal of this dissertation is to identify systematic approaches that shall support the mission set by World Health Organization (WHO): to eliminate TB globally by the year 2050. Measures might include addressing social barriers …

Lessons Learned From Cuba: Using Healthcare Systems And Stillbirth Rate Example, Ravi Patel

Master's Projects and Capstones

Cuba and the U.S. have different health care systems but similar health outcomes. In 2015 U.S. and Cuba had the same stillbirth rate. Cuba is a prevention-based system that is free for all, while the U.S. is a treatment-based system that uses a fee for service system. Cuba has ratified international laws that hold it accountable for improving health outcomes especially for women and children. The U.S. can learn from Cuba when it comes to improving health outcomes. The U.S. can improve their health outcomes by including more preventative based interventions and ratifying international law that will hold the U.S. …

Implementation Of A Fruit And Vegetable Voucher Program In San Francisco, Alexandra Kambur

Master's Projects and Capstones

Chronic disease has emerged as the predominant public health challenge of the 21st century. Chronic diseases like cardiovascular disease, cancer, type 2 diabetes and obesity have maintained their top positions as the leading causes of poor health, disability, death, and high health-care expenditures for over a decade. Health and hunger go hand-in-hand. Today over 15 million households in the United States struggle with food insecurity, meaning they do not have sufficient access to food that meets their dietary needs for an active and healthy life. The issue of food insecurity in cities like San Francisco, California is exacerbated by the …

Oh Baby! Evaluating The Impact Of Blossom's Natural Childbirth Prep Course On Women's Childbirth Experience, Florence Oxenham

Master's Projects and Capstones

The United States has some of the highest rates of maternal morbidity and mortality among developed countries. Comprehensive childbirth education is an important component of improving maternal health outcomes. This project was a pilot evaluation of a childbirth education course offered by Blossom Birth Services, a community-based non-profit organization providing resources for new and expectant families in the San Francisco Bay Area. A 41-item survey questionnaire was developed and administered to explore the impact of Blossom’s Natural Childbirth Prep course on women’s knowledge, feelings, and sense of self-efficacy regarding childbirth. Likert scales were used and thematic analysis of qualitative data …

No More Baby Steps: Preventing Unintended Pregnancies Of Los Angles Minorities And Adolescents, Rachel Bass

Master's Projects and Capstones

Previous studies have identified pregnancy intention to correlate with both maternal and fetal health. Though unintended pregnancy rates are dropping in America, they remain high among minority and young women. Contraceptive usage, a leading protective factor for unintended pregnancies, has been found to vary greatly by age and ethnicity. These two projects aimed to decrease unintended pregnancy rates through increasing patient knowledge of contraceptive options and correct usage. The first project focused on creating a comprehensive, oral contraceptive pill instructional handout for research participants of the birth control pill study. This handout was created through the analysis of compliance errors …

A Roadmap For The Journey Home - A Supplemental Tool Guiding Patients From Hospital To Home, Michelle Basco

Master's Projects and Capstones

Centers for Medicare and Medicaid (CMS) have recognized readmission rates as a public health problem. CMS incentivizes hospitals to reduce readmission rates and reduce payments for hospitals with high readmission rates (Berry et al., 2013). Patient education and discharge planning are associated with decreased readmission rates. I gained fieldwork experience at Children’s Health System of Texas in Dallas. Children’s Health, a pediatric non-profit, is the 8th largest pediatric health care provider in the U.S. Prior to discharge patient education occurs on topics related to their diagnosis, plus patients are provided discharge instructions including their diagnosis, medications, and simple instructions for …

Health Starts In The Home: An Assessment Of Efforts To Improve Occupant Health Through Healthy Building Materials In San Francisco’S Affordable Housing, Staci Hoell

Master's Projects and Capstones

Americans spend 90% of their lives indoors, and much of this time is spent at home, surrounded by building materials that typically have added chemicals like flame retardants, highly fluorinated compounds, and antimicrobials. Recent research has linked these chemicals to adverse health outcomes such as asthma, endocrine disruption, cancer, neurodevelopmental issues, and reproductive problems (Bayer et al., n.d.; Green Science Policy Institute). Furthermore, these chronic health conditions disproportionately affect low-income populations. Fortunately, substantial efforts in research, practice, and policy are working to reduce the use of these potentially harmful chemicals in building materials, particularly in San Francisco’s affordable housing sector. …

Obesity And Diabetes: Evaluating The Impact Of Promotores As A Prevention And Intervention Strategy In The Latino Community, Jessica Castaneda

Master's Projects and Capstones

This paper aims to examine obesity and diabetes among the Latino population as a health problem. As the largest minority racial group in the U.S, Latino rates of obesity and diabetes are greatly higher than whites. The prevalence of obesity in Latinos is 45% compared to that of whites at 34.5% (CDC, 2015). The disproportionate rates at which Latinos are affected by obesity and diabetes have prompted numerous programs to combat this health problem. Promotores or Latino community health workers have been able to provide the important piece of culturally and linguistically appropriate education for the population. Evidence shows Promotores …

Off To The Breast Start: Barriers To Exclusive Breastfeeding, Yasmin Mcbryde

Master's Projects and Capstones

Breastfeeding is a beneficial way to provide food for the healthy growth and development of infants. Breastfeeding also provides many health benefits for mothers. Review of evidence based data indicates that breastfeeding exclusively for 6 months is one of the healthiest and most natural sustenance for a baby. Unfortunately, there are many barriers that prevent mothers from breastfeeding for the recommended duration. The aim of this project is to assess the level of influence that cultural upbringing has on breastfeeding in public. I administered surveys to women and men for data collection. The findings indicate that participants have strong and …

Increasing Empathy And Conflict Resolution Skills Through Nonviolent Communication (Nvc) Training In Latino Adults And Youth, Marcianna Nosek, Maite Durán

Nursing and Health Professions Faculty Research and Publications

Background: Children of Latino immigrants often are torn between their native homes and new communities. Having supportive interpersonal relationships increases resilience to delinquent and violent behaviors stemming from immigration challenges. Communication fostering empathy may improve conflict resolution and supportive relationships.

Objectives: Community-based participatory research (CBPR) was conducted to evaluate the impact of nonviolent communication (NVC) trainings in Latino adults and youth.

Methods: Four sessions in NVC were provided by bilingual Latino trainers for Latino adults and youth. Pre- and post-training focus groups evaluated effectiveness of training.

Results: Three themes emerged from adult post training focus groups—enter the others’ shoes, making …

Mindful Mornings: Piloting A Meditation Group With Vulnerable Adults In A Drop-In Center, Iyo Kubota

Master's Projects and Capstones

An accumulation of stress and lack of coping resources can contribute to a higher incidence of mental and physical health disparities. Homeless adults are one of the most vulnerable subgroups who utilize Enterprise Resource Center, a peer-run day-center in Marin County. Because stress from multiple factors was identified in this transient and high-risk population, an intervention for stress reduction and management was explored. The findings from the needs assessment suggested that there was a need for an integrated approach for stress reduction and management. The challenge of sustaining a program was also highlighted during the needs assessment.

A brief mindfulness …

“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 …

Community-Based Asthma Intervention Programs And Their Impact On Childhood Health Outcomes And Burdens On The Healthcare System, Danika Ng

Master's Projects and Capstones

Since 1997, asthma prevalence rates have increased by 3% annually, leading to a current rate of 18.4 million adults and 6.2 million children with asthma, high hospitalization and emergency department visit rates, and an overall healthcare spending of 50 billion dollars. However, this increase in prevalence is disproportionately impacting children. Asthma is the third leading cause for hospitalization in children, have higher proportions of children being hospitalized with asthma symptoms, and have higher rates of asthma attacks. Recent literature shows that perceived lack of adequate education in areas such as medication adherence, medical device usage, asthma trigger avoidance, lack of …

Health Informatics Solution To Indoor Air Pollution: An Opportunity For Epidemiological Research, Rhys Fay Min Chua

Master's Projects and Capstones

Indoor air pollution accounts for the particulate matters and chemical compounds from outdoor sources that penetrate into the home environment. It also contains chemical particles from cleaning products, wall paints, personal care products, indoor combustion, and microbial agents. Mounting evidence links sources from indoor air pollution to sick building syndrome (SBS). SBS decreases human productivity, impacts learning abilities, and has the potential to trigger existing asthmatic symptoms, cause dizziness, nausea, fatigue, irritation to the lungs, etc. To improve the management of IAQ among population health and for environmental health to keep up with its technological counterpart, it is crucial to …

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, …

Exploring The Role Of Nutrition Education In Reducing Obesity Among The U.S. Adult Population, Nikitha Reddy Ravula

Master's Projects and Capstones

Obesity is a major concern among the low-income groups, yet the problem lacks adequate awareness. It is observed that the prevalence of obesity in the United States is increasing in the U.S., this paper is focused on obtaining information on low-income participants’ knowledge about consumption of nutritious food and its contribution in preventing obesity. This paper focuses on identifying the steps that participants have been taking to prevent obesity. To reach the goal of this qualitative study two surveys were designed by the researcher. From the study, it was found that majority of the participants were aware that consumption of …

The Fight Against Breast Cancer: A Policy And Programmatic Approach, Nandi Robinson

Master's Projects and Capstones

Abstract

Breast cancer continues to remain a significant health issue for women. Previously thought to only occur among postmenopausal women, breast cancer has impacted women of different ages; and rates of breast cancer have various impacts among different ethnic groups. For women living in a toxic environment, many of them have become the new wave of breast cancer cases. Screening and detection have succeeded in decreasing mortality rates. However, more research is needed in finding an efficient method of treatment. In the effort to assist in the fight against breast cancer through a policy and programmatic angle, I am fulfilling …

Safe Injection Facilities In The Tenderloin: Starting With Operational Plans, Bina Solanky

Master's Projects and Capstones

There are over 90 safe injection facilities (SIFs) in at least 11 countries around the world, except in the United States. SIFs are spaces where people who inject drugs (PWID) can bring their pre-obtained drugs in a hygienic space and use them under supervision. The goal of these sites is to reduce the harmful effects of injection drug use and refer PWID to other medical, social, and treatment services. The Safer Inside Coalition, a community-driven health initiative, in the Tenderloin district of San Francisco recommended opening a SIF in the Tenderloin to improve the health of the community and individual …

Retention In Health: Improving Hiv Retention Within The Sf Community Health Network, Miguel A. Ibarra

Master's Projects and Capstones

Previous work on HIV retention improvement has focused on improving access to care for communities who are either at-risk of falling out of care or who have difficulty engaging in medical care for the first time due to socio-cultural barriers. The San Francisco Department of Public Health (SFDPH), with the support of Project PRIDE, a CDC three-year demonstration project geared towards supporting health departments in implementing public health strategies to reduce new HIV infections within the men who have sex with men (MSM) and transgender communities, is seeking to improve HIV patient retention throughout the San Francisco Community Health Network …

Do Marketing Strategies Impact Condom Sales In Uganda?, Meyhar Mohammed

Master's Theses

What attracts people to buy condoms? HIV/AIDS remain one of the biggest health dangers of the world, especially in Sub-Saharan Africa. A lot of efforts have been pursued in the past two decades to drastically reduce prevalence of HIV and increase awareness about preventive mechanisms. In order to prevent relapse of success achieved so far, it is important to recognize transformation of consumer behavior due to growth in social networks, education and awareness over time. There are a lot of behavioral triggers captured by social marketing interventions in the field of public health. In an attempt to investigate the role …

The Impact Of Housing Insecurity On Community Health Outcomes: Exploring Collective Community Solutions And Housing Models In The Western Addition, Jacqueline V. Brown, Jacqueline Victoria Brown

Master's Projects and Capstones

In a city where housing is scarce and prices continue to rise, the lower income residents of the Western Addition are in panic. Historically, the Western Addition/Fillmore is ground zero for Urban Renewal. This community is still bouncing back from the negative effects of the out migration of Black residents, Japanese internment, and rapid gentrification. For twenty years, this part of the city was known as Harlem of the West due to its world-renowned Jazz and Blues composers, and is informally known as “Tha ‘Mo”. San Francisco has set the tone nationally for public, mixed income, and private housing that …

Inpatient & Outpatient Venous Thromboembolism: A Multifactorial Approach To Increase Mechanical And Pharmacological Prophylaxis Compliance, Suzanne E. Scheierling

Master's Projects and Capstones

Venous thromboemboli (VTEs) are a clinical and public health problem as they are commonly linked to inpatient experiences, yet frequently occur in the outpatient setting. VTEs place a significant burden on health care organizations and patients alike, as VTEs are costly, require long-term medications, and frequently reoccur. Research has identified risk factors and determined best practices for VTE prevention and prophylaxis, however little consensus exists among health care organizations and the implementation of best practices is varied. This project studied the challenges and opportunities in VTE prevention and prophylaxis at a large metropolitan hospital in California. Environmental changes were made …

Paying It Forward: Training Doulas As A Form Of Reintegration And Support For Communities Of Color, Sandra E. Luna-Martinez

Master's Projects and Capstones

As part of the birth justice movement in Alameda County, Roots of Labor Birth Collective (RLBC) is committed to support, empower and care for birthing members of the community. RLBC works to empower people of color with education and tools to have healthy babies and positive birth experiences regardless of their: gender, size, sexuality, orientation, culture or family structure. Healthy families begin with healthy communities and with that in mind, RLBC decided to tackle two major public health issues at once: recidivism and poor birth outcomes in communities of color. Doula training is not just an intervention to improve birth …

The Health Consequences Of Adverse Childhood Experiences: Building Resilient Communities, Elizabeth S. Najmabadi

Master's Projects and Capstones

Studies have identified that trauma experienced as a child directly affects your health later in life. In Sonoma County, one in four children have experienced two or more Adverse Childhood Experiences (ACEs) before the age of 18. Twenty-two percent of Sonoma County adults reported experiencing four or more ACEs before the age of 18. With the high rates of ACEs in our community this fieldwork placement aimed to bring awareness and build community capacity to understand and address ACEs and foster resiliency. To raise awareness in our community we developed the ACES and Resiliency Fellowship Series, which trained 60 fellows …

Optimizing Hiv Prep Implementation In The Primary Care Setting, Cara P. Nalagan

Doctor of Nursing Practice (DNP) Projects

Despite compelling evidence behind the efficacy of pre-exposure prophylaxis (PrEP) in preventing human immunodeficiency virus (HIV) acquisition and its introduction in 2012, the prescription of PrEP has remained low (Silapaswan, Krakower, & Mayer, 2016). At the Asian and Pacific Islander Wellness Center (API), an urban primary care clinic in San Francisco, suboptimal PrEP implementation was related to a lack of standardized practice and routine HIV risk screening for PrEP provision. A doctorate of nursing (DNP) project was implemented to initiate a standardized HIV risk screening protocol for identifying HIV risk and PrEP eligibility to increase PrEP implementation at API. The …

Exploring The Harmful Health Effects Of Chlorpyrifos On Children: An Argument For Policy Reform, Lucia M. Ruiz

Master's Projects and Capstones

Chlorpyrifos is an organophosphate neurotoxic insecticide, which poses a significant risk to children’s health. Exposure to chlorpyrifos during childhood, infancy and pregnancy has been linked to autism, ADHD, developmental delays, and lower IQ. My internship at the Natural Resources Defense Council in San Francisco consisted of completing analyses and creating science, policy and communications materials to support health protective policies for chlorpyrifos in the market and at the federal and state levels. Information pertaining to the widespread use and harmful effects of chlorpyrifos was gathered and presented in fact sheets, spreadsheets, graphs and bulleted talking points. Data analyses and literature …

Enhancing Nutrition Education And Physical Activities In Chinese Community: We Can! Chinese Family Campaign, Yi Feng Tan

Master's Projects and Capstones

Abstract

Early childhood obesity is a serious health problem in the United States. It has adverse and long-lasting consequences for children, parents and entire communities. The magnitude of the problem has increased dramatically over the last three decades. The high prevalence of obesity has significant health consequences and increases expenditures for health care. Although federal and state governments have a long history of fighting the problem of childhood obesity by formulating health policies and requirements, early childhood obesity in California has become an epidemic. In this paper I will introduce my fieldwork project, the We Can! Chinese Families Campaign, and …