Guiding Change: A Multidisciplinary Framework For Interventions Addressing Systemic Racism In Healthcare, Lavette D. King

Master's Projects and Capstones

The relationship between systemic and institutional racism in the U.S., and health outcomes in people of the African Diaspora have been well documented (Bailey et al., 2017). Distrust in the healthcare system is the result of generational trauma compounded by an ongoing issue that has yet to be fully addressed (Scharff et al., 2015). For decades people of African descent have expressed concern about negative experiences with the U.S. healthcare system. Often the encounters leave them feeling, mistreated, unheard and or criminalized. These feelings result in trepidation over using the healthcare system which often further compounds health issues (Washington, 2008). …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

California's Master Plan For Aging, Health Reimagined: A Case For Seniors To Age-In-Place, Remonia A. Bowie

Master's Projects and Capstones

Abstract

In 2021 Worldwide, communities face a singular yet common challenge; and this is the significant aging of their senior adult populations. Current evidence from the literature suggests that older adults prefer to stay in their homes as they age. However, the facilitators and challenges older people encounter in realizing their aging goals have been inadequately addressed by the current body of literature given the projected increase in the number of older people in the United States preferring to age from their homes. Aging adults are vulnerable to daily frustration, which could negatively impact their aging process. However, knowledge of …

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 …

Identifying And Structuring Long-Term Community Engagement Platforms For San Francisco's Ending The Hiv/Hcv/Sti Epidemics Initiative, Adam Landeros

Master's Projects and Capstones

Purpose: The primary objective for this project was to develop recommendations for a long-term community engagement structure and process for the ten-year implementation of the San Francisco Department of Public Health’s Ending the HIV/HCV/STI Epidemics initiative.

Background: Community engagement offers public health practitioners, researchers, and policymakers the opportunity for open, respectful dialogue with community members in pursuit of a common goal. This project was designed to explore different community engagement coordinators’ experiences with undertaking such initiatives, in order to inform a large-scale funding proposal being pursued by the San Francisco Department of Public Health (SFDPH).

Methods: Phase 1 of the …

Promoting Community Engagement Through Basic User Tutorial Of Epa Geospatial Screening Tools, Jonas Nguyen

Master's Projects and Capstones

Social inequalities are riddled with health disparities and outcomes leading toward lower life expectancy. Communities of color, low income, and rural neighborhoods lack the voice and resources to effectively oppose industrial settlement which would likely lead to the release of toxic wastes into the water, air and ground ultimately affecting residential health. Empowering members through community engagement is a relatively new strategic process where researchers are finding mutual benefits in design, implementation, and results. This study aims to identify and promote tools for community engagement within the scope of environmental justice by working with EPA geospatial screening tools and designing …

Plant-Powered: A Digital Plant-Based Nutrition Intervention For Low-Income Patients With Type Ii Diabetes, Ellen Pelos

Master's Projects and Capstones

Purpose: This project aimed to measure the acceptability and feasibility of plant-based diets among low-income individuals with type II diabetes at the Samaritan House Food Pharmacy and to create a user-centered pilot program to encourage the adoption of a plant-based diet.

Background: Plant-based diets are effective for preventing, treating, and reversing type II diabetes, but there is not much evidence about the acceptability and feasibility of these diets.

Methods: Focus groups were used to gather qualitative data about the acceptability and feasibility of plant-based diets in the target population. The researcher conducted interviews with Food Pharmacy program leaders to learn …

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 …

Redefining Trauma: Utilizing Restorative Justice To Repair Care Systems, Emebet Aklilu

Master's Projects and Capstones

This project examined the ways in which restorative justice programming can improve trauma informed care among the African American population in Oakland, CA. With 23% of African American men and women living at or below the poverty line in the United States, this project assesses gaps in current trauma informed care practices as evident in the literature. Following a rigorous document review the author coded and organized key programming components following six factors detailed by Rowher, Schoones, and Young (2014). Further examination of these program components was conducted using Bloom’s taxonomy levels to assess program outcomes associated with specific modules …

Art-Based Health Education For Homeless And Marginally Housed Women In San Francisco, Trineca R-N Godfrey

Master's Projects and Capstones

San Francisco currently has the highest rate of unsheltered homeless persons in the United States. Between limited resources and stigma many women included in this most vulnerable population are left with little to no support. Cis women as well as trans and non- binary people are at high risk for negative mental health outcomes due to violence (physical and psychological), stigma, lack of social support, societal marginalization, and the lack of healthcare. Lyon-Martin Health Services and the Women’s Community Clinic, in San Francisco’s Mission Neighborhood, caters to this community through its Outreach Department. Following a staff and outreach client needs …

Elevating Communities Into Self-Sufficiency Through Federally-Funded Health Partnerships, Nalleli Martinez

Master's Projects and Capstones

Purpose: This qualitative study is to identify programing that encourages increased self-sufficiency in SNAP recipients. The goal was to identify themes related to successful self-sufficiency programming at federally-funded health centers/health programs (HCHPs). The study also investigated the role of social determinants of health in relation to achieving self-sufficiency.

Method: A series of 45-minute to 1-hour-long interviews were conducted to explore the perspectives of seven total staff at seven federally-funded HCHPs across the U.S. western region. Using Nvivo, a qualitative data analysis software, responses were categorized into six themes: patient-centered care, one-stop-shop/integrated care model, community partnerships, organizational and staff support, leadership …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Creating A More Collaborative Tomorrow: Development Of A Patient Engagement Curriculum For A School Of Nursing And Health Professions, Alicia Digiammarino

Master's Projects and Capstones

Background: Healthcare has been moving steadily toward a patient-centered paradigm that seeks to involve patients more in their own care. Teaching communication skills to future health professionals can increase such patient participation. Despite the shift to patient-centered care, there is almost no training in patient engagement techniques provided to students at the University of San Francisco School of Nursing and Health Professions. Purpose: This project aimed to design and develop a sustainable patient engagement curriculum that meets the unique needs of faculty and students at the University. Methods: Interviews were conducted with eight faculty members to understand …

Reduing Hospital Readmissions: Ideal Discharge Planning For Heart Failure Management, Chun Mei Chen, Chun Mei Chen

Master's Projects and Capstones

Abstract

The objectives during this project were to achieve by the end of 2018 an overall reduction of 25% in HF readmissions within 30 days. By identifying root causes of readmissions and using needs assessment within the microsystem, literature highlights the elements defining interventions that can be used to improve transitions of care and reduce avoidable HF hospital readmissions. A plan was developed for integrating an evidence-based practice, IDEAL Discharge Planning, along with engaging patients and families at bedside from the first day of admission until discharge to more effectively assist staff in providing patient-centered education and self-care skills. The …

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 …

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 …

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 …

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 …

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 …

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 …

Implementation Of Patient Mobility Assessment Tool: A Clinical Nurse Leader Initiative Towards Improved Patient And Nurse Health Outcomes, Janet Lopez

Master's Projects and Capstones

Abstract

Early ambulation during hospitalization has been recognized as a fundamental and logical intervention to reduce patients functional decline and muscle weakness. Recently, our healthcare system is encouraging nurses to become more actively involved in assessing patient’s mobility status and managing their mobilization. However, since the high nursing workload affects the time that a nurse can assign per task, more often than not they have little time to accurately assess patient’s mobility status; Presenting a safety concern for nurses and patients. In an effort to ease this challenge, the Patient Mobility Assessment Tool (PMAT) is introduced as an efficient nurse-driven …

Response To Quality Of Life Surveying: An Analysis Of Patients With Wiskott-Aldrich Syndrome, Tara Bani-Hashemi

Master's Projects and Capstones

Patient-reported outcomes and surveying has increased in clinical settings in order to assess outcomes and patient health status. However, there is a lack of these assessments from a pediatric standpoint, an inpatient standpoint, and family perspective. In addition to health status and overall clinic experience, expanding the self-reported evaluation to include quality of life on physical and psychosocial levels will provide a more comprehensive evaluation of the patients’ health services. The PedsQL ™ scale scores four domains: physical, emotional, social, and school/work functioning. It includes a parent-proxy report as well as self-report for patients ages 5 to 18 years. Infant …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

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 …

Unicef Kid Power: Empowering Kids To Get Active And Save Lives, Emily L. Gudaitis

Master's Projects and Capstones

UNICEF Kid Power is a program aimed at increasing U.S. children’s activity levels by tapping into children’s intrinsic desire to do good. Through their activity levels, kids earn points, which unlocks funding from partners that will support treatment for a malnourished child. This one-of-a-kind program was implemented in the Bay Area in Spring 2016 with 7,800 youth participants. The attached paper is a summary of a 300-hour fieldwork experience at the U.S. Fund for UNICEF assisting with the UNICEF Kid Power implementation in the Bay Area. The fieldwork included program implementation and evaluation, presentations at participating schools in the area, …