Community Health and Preventive Medicine Commons^™

Machine Learning Approaches To Understanding And Predicting Cancer Screening Follow Through With Population And Health System Data, Matthew Davis

MUSC Theses and Dissertations

Introduction

Cancer is the second leading cause of death in the United States and cancer screening is a primary tool to reduce mortality. However, not all who are recommended to be screened actually follow through. This study investigates whether electronic medical record and geographic data is suitable to predict which patients are at risk of missing recommended screenings. The goal of this investigation is to design a data informed system that can automate the prediction of those at risk for missing screenings and provide insights into underlying reasons. This will enable resources to be focused to increase cancer screening adherence, …

Intimate Partner Violence Screening In The Emergency Department, Rebecca Stuerman

Dissertations

Problem: Intimate partner violence [IPV] is a public health concern that affects one in three women worldwide. IPV can be addressed through identification and early intervention with minimal risk to the patient. The emergency department is an important setting for screening given the frequency with which people who experience abuse may present with IPV-related injuries and other related concerns (depression, suicidality, etc.). Successfully implementing a validated tool for screening and providing early access to resources and referrals may help to mitigate the longterm negative impacts of IPV. The need for increased staff education was a major barrier to screening for …

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Marijuana Vaping In Adolescents: Evaluating Provider Knowledge And Practices To Improve Screening And Referral To Treatment, Holly T. Whitcomb

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Vaping is a public health epidemic. Adolescents are using cannabis electronic vapor products at increasing rates. In teens, rising E-cigarette and vaping product use associated lung injury (EVALI), tetrahydrocannabinol (THC) intoxication and addiction are concerning. Primary care providers are in a unique position to screen and discourage adolescents from vaping, yet barriers to screening and referral to treatment exist.

Objective: This project provided education on vaping trends, Screening, Brief Intervention, and Referral to Treatment (SBIRT), and Screening to Brief Intervention (S2BI) with the goal of improving screening and brief intervention of at-risk adolescents among primary care providers.

Methods: The …

Increasing Food Insecurity Screening, Coding, And Referral Among Emergency Department Providers, Jennifer Lee Watkins Bsn, Rn, Dnp-C

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background & Purpose. Food insecurity (FI) affects 1 in 9 Vermonters (Feeding America, n.d.), and is associated with many poor health outcomes and healthcare expenses (Malecha et al., 2018). Research identifies emergency departments (EDs) as key settings to address FI in high-risk populations (Cullen et al., 2019), guiding this project to the ED of a Critical Access Hospital and Federally Qualified Health Center. This project intended to increase ED providers’ knowledge and utilization of food insecurity screening (FIS), use of FI billing code Z59.4, and subsequent referral to the Community Health Team (CHT). Specific aims included: identify existing …

The Primary Care Provider’S Role In Screening And Intervening In The Human Trafficking Of Adolescents: A Systematic Literature Review, Brittany Schmid

All Graduate Theses, Dissertations, and Other Capstone Projects

Human trafficking (HT) is a growing concern within the United States (U.S.) and internationally. With the alarming number of HT victims presenting for medical care, primary care providers (PCPs) are in a unique and privileged position to encounter HT victims within the healthcare system. Adolescents, in particular, are vulnerable to HT because of minimal life experiences, inadequate social support, and limited coping mechanisms (Ertl et al., 2020). Failure to recognize and intervene in cases involving HT victims who are minors is detrimental to the individual’s health, wellbeing, and safety. With the assistance of education and training, community resources, guideline adoption, …

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

Screening For Palliative Care Services In An Assisted Living Facility, Maria Delia Crosby

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Palliative care services remain under-utilized, even as evidence suggests that early palliative care leads to positive health outcomes, reduced ED visits, and substantial cost savings. Barriers include a lack of knowledge of palliative care services in the community, and under-utilization of validated assessment tools, including a symptom checklist. Aims of this project: 1. To determine whether the integration of validated community-based palliative care screening tool in an assisted living setting will identify older adults with unmet palliative care needs. 2. To determine if tool implementation could lead to a referral for palliative care consultation.

Methods: A screening tool developed …

The Difference In Barriers To Colorectal Cancer Screening Between Men And Women In The 45-55-Year Age Group, Maren Christina Davis

All Graduate Theses, Dissertations, and Other Capstone Projects

Statement of the Problem: Adults, 50 years or older, should have a screening colonoscopy every ten years and fecal immunochemical test (FIT) every year. However, close to 22 million adults between the ages of 50-75 in the U.S. have never been screened for colorectal cancer, which delays treatment and can be fatal if the cancer is not found in time.

Procedure: This study used a descriptive, cross-sectional, survey-based design and a convenience sample of men and women between 45 and 55 years old to assess colorectal screening practices, barriers to screening, and knowledge levels about colorectal cancer screening.

Findings: A …

Pharmacist Perceptions Toward Screening, Brief Intervention, And Referral To Treatment For Prescription Opioid Misuse: Initial Instrument Reliability And Validity, Tara Fouts

Boise State University Theses and Dissertations

Prescription opioid misuse has become a growing problem in the United States, and there has been a significant increase in the number of nonfatal overdose and overdose deaths since the 1990s. Idaho has also experienced an increase in the number of drug-induced deaths over time, increasing nearly 30% from 2012 to 2016. The Centers for Disease Control and Prevention indicates overprescribing and dispensing of prescription opioids is a main driver to the increase in overdoses. Evidence-based early intervention methods, such as screening, brief intervention, and referral to treatment (SBIRT), can be utilized in health care settings to identify risky behaviors …

Analysis Of A Universal Depression Screening Workflow At An Integrated Healthcare Center, Arthur Roehr

Doctor of Nursing Practice Final Manuscripts

Purpose: Evaluation of an evidence-based protocol that measures the effectiveness of universal depression screening at an integrated healthcare center. At risk patients are those who complete a patient health questionnaire (phq-9) and score ≥ 10 when presenting for a primary care visit. A score of ≥ 10 prompts further evaluation by the primary care provider (PCP) prior to behavioral health care management (BHCM) referral.

Background: In 2016, 16.2 million adults aged 18 or older in the U.S. experienced a major depressive episode (MDE). 65.3% of those received some form of treatment from a healthcare professional (therapy and/or medication). Early identification …

Blood Pressure Screening Practices Among Dental Hygienists, Mariah Sullinger

All Graduate Theses, Dissertations, and Other Capstone Projects

“There is consensus on the importance of early detection and treatment of hypertension and dental care is one of the few medical services which involves a considerable proportion of the population returning for routine check-ups” (Berne, Engstrom, Gahnberg, & Svardsudd, 2011, p 194). Little is known about the frequency and consistency of blood pressure screening practices or barriers affecting these procedures. Research findings may support efforts to increase or routinize scope and frequency of this preventive procedure among dental healthcare providers or make it a standard of care. Data from the survey was used to assess what type of setting …

Increasing The Adherence To Updated Clinical Practice Guidelines For Tb Screening Among Hiv Patients Entering A Congregate Setting Utilizing A Clinical Reminder, Domingo Lopez

Doctor of Nursing Practice

Purpose: The purpose of this Doctor of Nursing Practice project was to update an existing tuberculosis policy for screening HIV-positive individuals entering a south Texas jail to meet current evidence-based guidelines and increase the adherence of jail staff to the updated screening process.

Background and Significance: In 2015, over 700,000 people were jailed in the United States with over 20,000 being HIV-positive. Tuberculosis is highly contagious and spreads through the air. HIV is a virus that targets the immune system. HIV-positive people are 17-22 times more likely to contract tuberculosis. The current screening process at the jail showed a low …

What Are The Most Commonly Used Tools To Screen Depression In Hiv-Infected Gay And Bisexual Men?, Michael Isner

Honors Undergraduate Theses

Gay and bisexual men infected with human immunodeficiency virus (HIV) comprise a sizable, medically vulnerable population. Depression is the most commonly experienced mental health disorder affecting this group of people, lending itself to a host of risks associated with depression. As screening of depression in this population can be challenging, it is vital that clinicians have the best available tools and guidelines to detect depressive symptomology. This focused, comprehensive review of the literature examined current data describing the clinical instruments used to detect depressive symptoms in HIV-infected gay and bisexual men. The aim of this analysis was to seek out …

Asthma Control Screening Using The Electronic Health Record, Accursia A. Baldassano, Jonathon Mack

Doctor of Nursing Practice Final Manuscripts

ABSTRACT

Experts in asthma care globally recommend screening for asthma control in all patients with asthma through the use of an evidence-based tool. This project embedded the Asthma Control Test (ACT) in the electronic health record to determine if screening for control would change compared to standard care.

Methods

An electronic template of the ACT was embedded in the electronic health record system for a community faith-based family medicine clinic. All patients 12 years and older with a previous diagnosis of asthma were included in this project. These patients were screened for asthma control using the template at every appointment. …

Documentation Of Smoking History And Adherence To The Uspstf Recommendation For Lung Cancer Screening: A Retrospective Chart Review, Laura A. Golden

DNP Projects

Purpose: The purpose of this project was to evaluate provider compliance with documentation of smoking history and, if criteria met, referral for lung cancer screening as recommended by the United States Preventive Services Task Force in 2013.

Methods: A retrospective chart review was conducted using an electronic medical record (EMR) at a large, rural community family practice clinic. Patients meeting inclusion criteria of having a smoking history (current or past) of 30 pack years, aged 55 to 80 years, and no history of lung cancer diagnosis were included for randomization. One hundred patients were selected from 300 randomized charts; five …

The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

Mammography Screening Practices And Health Beliefs Of Women In East Tennessee, Peggy A. Johnson

Doctoral Dissertations

Abstract One of every eight women in the United States will be diagnosed with breast cancer in her lifetime. Although early detection of breast cancer is the most effective method of assuring survival, many women throughout the country do not avail themselves of this advantage. This study examined mammography screening practices of women age 55 and older who attended senior citizen centers in rural, non-metro, and metro counties in the areas designated by the Tennessee Department of Health as the Eastern Grand Division of Tennessee. Data was collected from four hundred women from fourteen counties in East Tennessee using the …