Community Health Commons^™

Home And Community Reintegration In Chronic Phase Guillain Barre Recovery, Avani Johnson, Cassandra Nelson

Spring 2024 Virtual OTD Capstone Symposium

To improve the transition of individuals with Guillain Barre Syndrome (GBS) to their homes and communities following the onset of their condition, Avani Johnson, OTS, CPT, in partnership with Able Faith, Inc. and key stakeholders will present a poster presentation on the development of a home and community reintegration program. The overarching goal of this project was to identify the efficacy of community reintegration programs in yielding effective transitions to home and community roles for individuals with (GBS). This was completed through the development and implementation of a home and community reintegration program at a community center located within the …

An Ot Needs Assessment For Children And Families Residing In Shelters, Jessie Siono, Susan Macdermott

Spring 2024 Virtual OTD Capstone Symposium

This study created a needs assessment is to determine the unique occupational deficits of children and their families in California experiencing homelessness within a shelter setting via recording their lived experiences. A local family shelter was analyzed via observation and interviews with staff and residents of the shelter. The results were compiled into a facility assessment to identify supports and barriers to occupation. Results were also utilized to complete an occupational needs assessment for families and children living in homeless shelters. The study determined the occupational needs and occurrences of occupational deficits that were experienced by residents of the family …

Evaluating A Training Program For Rural Doctors And Nursing Home Staff On Safe Medicine Use For Patients With Dementia And Nursing Home Residents, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Program goal: Reduce unnecessary use of certain medications without worsening symptoms

Comparing Universal Versus Targeted School Screenings For Depression Among Teens, Research Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

The US Preventive Services Task Force endorses universal adolescent major depressive disorder (MDD) screening in primary care; however, most adolescents lack preventive health care, resulting in worsening disparities in MDD screening and treatment.

Comparing Long-Term Outcomes Of Two Collaborative Care Approaches For People With Depression, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

People with depression usually get treatment in healthcare settings, such as clinics. In communities with few resources, people may also get help in community settings such as social services agencies or churches. Collaborative care brings together healthcare and community programs to help people with depression.

Comparing Cognitive Behavioral Therapy (Cbt) Versus Yoga For Helping Older Adults Address High Levels Of Worry, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Some older adults have high levels of worry that cause them to feel restless, tired, or tense. Two ways to treat worry are Cognitive Behavior Therapy (CBT) and yoga.

Treating Chronic Pain Using Approaches Adapted For Patients With Limited Reading Skills, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Patients with chronic pain may find some psychosocial interventions to be effective but for those with limited reading skills, it can be hard to understand and use these options.

Behavioral Health Integration And Outcomes That Matter To Patients: A Longitudinal Mixed-Methods Observational Study, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

The study team hypothesized that patients would have a better experience over time in clinics that had greater degrees of behavioral health integration.

Comparing Two Ways To Treat Serious Worry Among Older Adults From Underserved, Racial Or Ethnic Minority Communities, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Compared with other older adults, those with serious worry are more likely to have poor physical health, and often have depression, sleep problems, and trouble thinking clearly..

Is A Patient Navigation Program More Helpful Than A Referral Program For Reducing Depression And Improving Quality Of Life Among Women Living In Neighborhoods With Few Resources?, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

The research team compared two programs designed to help women with feelings of depression who live in neighborhoods with few resources. Both programs lasted four months.

Examining Health Outcomes For People Who Are Transgender, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

The Study of Transition, Outcomes, and Gender was initiated to assess morbidity among transgender people in general and after gender-affirming treatments.

Helping Patients With Mental Illness Engage In Their Transitional Care, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Effective transitional care can keep patients from going back to the hospital.

Examining Effects Of State Policies To Monitor Mental Health Medicines For Children In Foster Care, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Antipsychotics can have long-term risks but help treat conditions like schizophrenia.

Increasing Patient Awareness And Education Surrounding Prescription Weight Loss Medications, Anirudh A. Hirve

Family Medicine Clerkship Student Projects

Obesity is a growing problem in the United States. While it remains important for clinicians to emphasize health supportive behaviors including dietary modification and exercise when counseling patients, the advent of new weight loss medications has created a need for patient education materials regarding these interventions for a growing number of patients who request them at primary care visits. This project created a smart phrase in the electronic medical record summarizing weight loss medications currently available on the market to transform patient counseling and enable better shared decision making between patients and providers.

Do Group Medical Visits With A Focus On Mind And Body Help Patients With Chronic Pain And Symptoms Of Depression?, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Health centers can use the results when considering how to help patients with chronic pain and depression reduce their use of pain medicines.

Comparing Ways To Ask Patients About Sexual Orientation And Gender Identity In The Emergency Department (Ed), Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Sexual and gender minority patients report higher satisfaction and comfort with ED encounters when SO/GI is collected along with other demographic information via a nonverbal, written method during patient registration.

Comparing Two Telehealth Approaches For Treating Psychiatric Disorders In Primary Care, Research Dissemination Committee, Maine, Usa

REACH: Research Evidence-to-Action for Community Health

Federally Qualified Health Centers (FQHCs) are community clinics that provide primary care in rural and other underserved areas. FQHCs often don’t have enough mental health specialists to treat patients with complex mental health conditions.

照顧者實用資訊手冊, 嶺南大學亞太老年學研究中心 Asia-Pacific Institute Of Ageing Studies, Lingnan University, Meng Soi, Florence Fong, Chak Kwan, Dickson Chan, Kin Chung Cheung, Lai Ieng Jay Lau, Sin Yui Sharon Chan, Kin Ho William Li, Ka Ho, Alan Li

Manual & Guide 手冊及指引

手冊源起

香港面對人口高齡化，醫療和福利系統無可避免面臨持續的挑戰。照顧者因壓力問題而引發的家庭悲劇時有發生，反映照顧者自身亦極需要社會的重視和支援。

現時照顧者人數眾多，當中不乏配偶、父母、子女、女婿、媳婦，對長者照顧及社會無酬的付出，確實值得社會的認同和肯定。然而，儘管本港為長者及照顧者提供不少支援服務，由於不同的原因，照顧者似乎未有善用現有的服務，常常需要一力承擔所有照顧的責任，這無疑增加了他們的壓力。

照顧者需求多樣性

照顧者有不同種類，所需要的服務或支援亦有所不同。例如：「新手照顧者」剛開始接觸照顧工作，需要盡快提升日常護理和相關的疾病知識，以及獲得合適的離院/復康服務支援。「隱蔽照顧者」一直承擔照顧工作但沒有接受任何支援，因此，他們需要的是服務提供者/鄰里的主動接觸，並被轉介合適的照顧服務，以分擔他們部分照顧工作。「高危照顧者」幾乎長時間被照顧的工作佔據了其生活，他們需要的是喘息空間和暫託服務，甚至可能是情緒支援。即使「資深的照顧者」也可能需要喘息或暫託的支援服務去減輕壓力；而結束了照顧工作的「畢業照顧者」，無論是情緒的支援，還是重新規劃財務與就業的安排，都有非常實際的需求。基於照顧者的不同需要，照顧者的支援和服務也是多樣化，如何讓不同種類的照顧者能夠輕易了解現有的社區支援服務、可考慮甚麼因素選取相關服務、如何獲取所需的支援包括申領經濟支援或預早準備長期護理開支、如何自強增值等，都是這本手冊希望解答的問題。

手冊的目的

編製這本手冊的目的就是要減少照顧者四處尋找資訊的麻煩，提供一個整全且易於瀏覽的資訊來源。本手冊主要有兩大目標：其一，幫助照顧者認識不同的服務和資源，積極尋求援助；其二是一站式提供豐富的資訊服務，提升照顧者的能力和平衡身心健康。

手冊的意義

此手冊的社會意義是期望提高大眾對照顧者需要的關注，並引導更多的行動以支援照顧者。如果您的親友是照顧者，又或您認識的朋友甚至鄰居正面對照顧家人的困難，您可以主動伸出援手，又或利用這本手冊作為啟示，向他們介紹相關的服務。

另外，這本手冊可以視作為支援照顧者的工具，讓照顧者明白在承擔照顧家人的重任時並不需要孤軍奮戰，也可以善用社區提供的各種資源和服務。

手冊架構

本手冊由四個主要部分組成，每部分都專注於特定的主題，旨在提供照顧者的全方位支援和資訊，幫助他們在面對挑戰時能夠有所依賴，並從中獲得力量：

第一部分主要提供基礎知識，其中包括不同種類的照顧者的介紹、四種長者常見疾病（包括認知障礙、中風、老年抑鬱和癌症）的病徵說明、以及照顧者可能面臨的壓力與「喘息服務」的重要性。第二部分專注介紹長者常用的社區及健康服務。我們按照地區將服務機構進行了分類，羅列「認知障礙、中風、老年抑鬱、癌症」常用的服務機構，此外，我們還提供家居安全、樂齡科技租賃服務，以及財務支援等相關建議。第三部分將焦點重新放回照顧者身上，提供了支援照顧者的社福機構介紹、照顧者同路人的心得分享，以及照顧者的培訓資訊，旨在幫助照顧者在面對困難時能自強不息。最後，在本手冊的結尾部分，我們特別邀請了四位專家學者就照顧者政策提出見解和建議，為加強照顧者支援服務提供新思路。

如果按持份者來分類，手冊的四個部分的重點如下：

第一部分：照顧者的基礎知識

◎ 針對預備照顧者、新手以及隱蔽照顧者，讓他們了解照顧者的角色和需要；照顧體弱長者的基礎知識，並提供應對壓力的建議，包括自我照顧和喘息服務等。

第二部分：照顧者支援

◎ 針對所有護老者，提供長者常用的社區服務、健康服務和支援計劃，包括暫託、住宿、護送及陪診、善別支援、情緒支援、復康用品津貼及租賃的支援計劃，以及財務策劃師提供的理財貼士。

第三部分：照顧者自強

◎ 針對照顧者，資訊包括不同的照顧者支援組織、同路人和畢業照顧者的經驗心得、培訓課程，以及實用的電子資訊平台推介。

第四部分：對照顧者支援政策的看法和展望

◎ 針對服務提供者、政策倡議者及制定者，提供專家學者對照顧者服務及政策的未來發展方向的看法和建議，以期引發更多關於「如何為照顧者提供更好支持」的討論。

給讀者的使用指引

本手冊內容十分豐富，讀者可以先瀏覽目錄，選擇與您相關的部分進行細讀。對於新手照顧者或剛接觸/關注護老服務的人士(例如：學生、社區人士)，我們建議您可以參考手冊第24-33頁「給照顧者的智慧錦囊」的個案，了解不同照顧者可能面對的情境，這可能會給您一點概念，讓您可以考慮尋求哪些支援服務，又或您身邊照顧者朋友有哪些需要，以及如何協助他們獲取所需要的支援。我們深知閱讀本手冊時，您可能會遇到一些不明白的地方，請不必感到困惑。您可以嘗試找身邊的朋友、鄰居或社會服務機構的工作人員一起閱讀，或者向本中心的職員進行查詢。

此外，為方便讀者可以隨時隨地閱讀而不需要攜帶整本手冊，我們為本手冊設立了一個專屬網頁，免費下載整本手冊或某些章節內容。

希望您在閱讀的過程中能找到有用的資訊，並能從中獲得實際的幫助。

Community Reintegration Of Formerly Incarcerated Persons: An Occupational Therapy Guidebook, Shauntrice Woodberry, Angela Labrie Blackwell Phd, Otr, Steven Gerardi Phd, Otr

Summer 2023 Virtual OTD Capstone Symposium

The recidivism rates in the US are the highest, as the current research suggests the majority of offenders (two-thirds) released from prison in any given year will be reincarcerated within three years (Eggers et al., 2006). The high rates of recidivism suggest that the criminal justice system has not been able to successfully identify the needs of incarcerated individuals necessary to support the success of their community integration process.

Since there are no published guidelines available to OT practitioners to guide their provision of community reintegration services to formerly incarcerated persons, the product of this capstone was a guidebook.

Exploring The Post-Surgical Needs Of Guatemalan Children And Their Families From Low Socioeconomic Status (Ses) Communities Using An Occupational Therapy Perspective, Diana Del Carmen Tojin Romero, Karen Aranha, Angela Labrie Blackwell

Summer 2023 Virtual OTD Capstone Symposium

Background: Despite a decline in infant mortality rates in the Global South (GS), there has been a rise in congenital and developmental disabilities. International short-term medical (ISTM) missions in Guatemala seek to address the surgical needs of children from low SES communities, but the understanding of the impacts of such assistance and the post-surgical needs of these communities remains limited. Embracing the Human Rights-Based Approach (HRBA) to healthcare as a foundation for this study recognizes health as a fundamental human right. The main tenets of this approach will guide this investigation to understand the post-surgical needs of children and their …

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).

The Perceived Benefits Of Belonging To A Community Organization For People With Parkinson's Disease (Pwpd): An Ethnographic Study, Alexis Fortes, Mary Ann Smith, Karen Aranha, Kelli Cabrera

Summer 2023 Virtual OTD Capstone Symposium

Background: Persons with Parkinson’s (PwPD) seek to age in place and slow the functional decline that comes with the disease process. Membership in community-based and fitness programs provides a social safe environment that significantly impacts an individual’s psychological well-being and occupational independence. The American Occupational Therapy Association (AOTA) supports and promotes partnering with community organizations that promote and valuemaintaining occupational independence for community dwellers.

Objective: This study investigated the perceived benefits of belonging to a community organization that supports health management and well-being for PwPD.

Methods: A qualitative ethnographic study used immersive participant observation, and conducted two …

Examining The Utility Of The Canadian Occupational Performance Measure (Copm) Vs. Cognitive Mapping And Motivational Interviewing (Cm/Mi) To Provide Person-Centered Care (Pcc) For People With Parkinson’S Disease (Pwpd), Mary Lagasca, Karen Aranha

Spring 2023 Virtual OTD Capstone Symposium

Background: Parkinson’s disease (PD) limits occupational engagement and quality of life. Clinicians need tools to help understand the lived experiences of people with PD to provide more person-centered care (PCC). The Canadian Occupational Performance Model (COPM) is one tool used with this population, but its predetermined categories may be limiting. In contrast, Cognitive Mapping and Motivational Interviewing (CM/MI) is a non-standardized method that may provide more insight. Objective: To identify the benefits of the COPM to CM/MI in delivering more person-centered care (PCC). Methodology: A qualitative phenomenological self-study was used. Data collection compared the assessments and reflected on determining if …

Pathways To Care Of Maine Youth With Psychosis, Elizabeth M. Mutina, Rebecca Jaynes, Dave Weiss, Elizabeth Bernier, Kristen A. Woodberry

Costas T. Lambrew Research Retreat 2023

Study clinicians conducted semi-structured interviews to identify the timing and steps of each person’s Pathway to Care (PtC).

“I Know My Body Better Than Anyone Else” Perspectives Of People Who Inject Drugs On Antimicrobial Treatment Decision Making For Serious Infections, Amy Eckland, Michael Kohut Phd, Henry Stoddard, Debra Burris, Frank Chessa, Monica Sikka, Daniel Solomon, Colleen Kershaw, Ellen Eaton, Rebecca N. Hutchinson, Peter Friedmann, Thomas Stopka, Kathleen Fairfield, Kinna Thakarar

Costas T. Lambrew Research Retreat 2023

Introduction:

• Few studies have examined the perspectives of patients with lived experience regarding outpatient treatment options for injection drug use (IDU) associated infections.

• We sought to better understand the perspectives of both community partners with lived experience who work with people who inject drugs (PWID) and hospitalized patients with IDU-associated infections on shared treatment decision making.

The Past, Present, And Future Of Distress Screening: Launching A Robust Distress Screening Program At A Large Outpatient Medical Oncology Practice Serving Rural/Underserved Communities, Kevin Stein, Trisha Warren-Vanhorn, Meredith Curtis, Amy Litterini, Amit Sanyal

Costas T. Lambrew Research Retreat 2023

After redesign, administration of the DT at initial chemotherapy teaching sessions and robust searchable databases integrated with EHR systems, allowing providers/researchers to create reports filtered by date ranges, encounter type, clinical site/facility, scores of ≥4, domain (physical, emotional, practical), and outcome (referral to specialist)

Community Healthcare Providers’ Perspectives On Hiv Pre-Exposure Prophylaxis (Prep) Use Among Black Women, Kayla Pitchford, Sylvia Shangani, Charlotte Dawson, Kristin Heron

College of Sciences Posters

The most at-risk population among women for HIV diagnosis in the U.S. are Black women, who account for 61% of all new HIV cases. Pre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention method for people at risk of HIV acquisition. Despite being disproportionately affected by HIV, Black women’s knowledge, perceived benefits, and uptake of PrEP remain low. The socio-ecological model may be useful for understanding why there is a low uptake of PrEP among Black women by examining the complex interplay between individual, relationship, community, and societal factors. The current study used the socio-ecological framework to explore provider …

Studios: New Tools At Mainehealth To Improve Research And Engage Stakeholders, Carrie Sullivan, Paige Aherns, Emma Daybranch, Lisbeth Balligan, Elizabeth A. Jacobs, Susan L. Santangelo

Costas T. Lambrew Research Retreat 2023

An introduction, description of benefits, and additional information about the new tools of the studios at MaineHealth.

Reshaping The Narrative, Crystal Little Owl

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.

Community Resilience In Vermont After The 2023 Flooding Event, Alex Poniz

Family Medicine Clerkship Student Projects

Between July 10th-11th 2023 Vermont experienced catastrophic flooding after receiving prolonged heavy rainfall of up to 9” over 48 hrs. Damage from the 2023 event rivals the historic destruction of Hurricane Irene in 2011 and is exceeded only by the Great Vermont Flood of 1927, an event predating modern flood controls. We collected oral histories from Vermonters to better understand their lived experience of the flood and its impacts, and identifed common themes related to community and individual resilience.