Medicine and Health Sciences Commons^™

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

Modifiable Health Disparities And Cardiovascular Disease Risk Factors In Latino Migrant Seasonal Farmworkers: A Meta-Analysis, Cindy Mendez

Nursing Theses and Dissertations

BACKGROUND: Cardiovascular disease is the leading cause of death in the United States (U.S.). Existing literature concluded that Latino migrant seasonal farmworkers endure higher rates of adverse health disparities and chronic diseases than the general U.S. population. However, research on the Latino migrant seasonal farmworkers’ modifiable health disparities (i.e., alcohol use and smoking) and cardiovascular disease risk factors (i.e., high cholesterol, diabetes mellitus, hypertension, and overweight/obesity) is scarce, particularly studies comparing male and female Latino migrant seasonal farmworkers. PURPOSE: This meta-analysis had two aims. First, examine whether male or female Latino migrant seasonal farmworkers in the U.S. have …

Nursing-Related Interventions To Obstetric Violence: A Literature Review, Annaliece M. Balensiefen

Honors Undergraduate Theses

The aim of this literature search was to explore the prevalence of obstetric violence and identify nursing interventions that could potentially prevent the mistreatment of pregnant women in the United States healthcare system. Background: The topics of obstetric violence and healthcare disparities have been gaining awareness. Other countries have a larger body of research for obstetric violence compared to the U.S. Methods: CINAHL Plus with Full Text and MEDLINE databases were utilized. Global perspectives were considered in conjunction with the U.S. and specifically Florida. Healthcare disparities in obstetric care were identified, based on race, ethnicity, socioeconomic status, sexuality, disability, …

Screening People Experiencing Homelessness For Adverse Childhood Events (Aces), Priya Vishwanath

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to implement a screening tool identifying patients who have four or more Adverse Childhood Events (ACEs) and connecting them to resources to build protective resilience. Stress during the developmental years can lead to preventable health conditions that are costly and impede quality of life. Nine out of the ten leading causes of death are ACE related illnesses. These are caused by complications of toxic stress syndrome. During a 7-month period, 138 patients were screened; 45% had ACEs of four or more.

Improving Patient Satisfaction And Preventative Health Service Utilization For Limited English Proficiency Immigrants At Pearl Medical Centr, Chioma Holland

Graduate Theses, Dissertations, and Capstones

Background: Despite research efforts to address health disparities within immigrant communities, immigrant health continues to lack the attention from healthcare stakeholders it needs. Many immigrants already face dire health threats like extreme poverty, political unrest, and mental health concerns in their countries of origin, making them even more vulnerable to poor physical, mental, and social health outcomes upon arrival to the United States (U.S.). The purpose of this project was to improve patient satisfaction and increase immigrant use of preventative care by utilizing appropriate interpreter services. Method: The Quality improvement (QI) project involved surveying limited English proficiency (LEP) immigrants older …

Increasing Obesity Education In An Underserved Latino Population, Morgan Lippert, Kelsey Beard

Doctor of Nursing Practice Projects

Obesity is a rapidly growing health problem in the United States. Certain populations are at high risk for developing obesity including the Latino population and underserved communities. This Quality Improvement project aimed to develop a more patient centered approach for primary care providers use to deliver obesity education to an at-risk Latino population. The project was completed at a clinic in southern Illinois where the majority of the population is underserved and Spanish speaking. Obesity education tools in both Spanish and English were given to the patients in order to decrease the language barrier and improve patient education and understanding …

Black Hearts Matter: A Comparative Study Of Sociodemographic, Clinical, And Psychosocial Characteristics In Black And White Persons With Heart Failure, Hannah M Anderson Hughes

Theses and Dissertations

Heart failure (HF) is a chronic, progressive, debilitating illness that disproportionately affects Black individuals, often leading to poor quality of life (QOL). Various sociodemographic, clinical, and psychological characteristics are related to QOL in patients with HF. Because most studies do not include representative Black samples or report findings from racial subgroup analyses, these relationships and any existing racial differences are not well understood. The purpose of this descriptive, comparative study was to explore the relationships among sociodemographic, clinical, and psychological characteristics and QOL in patients with HF and to determine if there were racial differences between Black and White individuals. …

The Value Of An Educational Curriculum For Community Health Workers To Decrease Health Disparities, Mandeep K. Gill

DNP Qualifying Manuscripts

Abstract:

Introduction: Community health workers (CHWs) are a group of health care workers that work with underserved populations in rural areas. Community health workers seldom require any formal education for their role, which may cause disparities in the information they present to the populations they serve.

Problem: Underserved communities contain many low-income and marginalized populations that do not have access to adequate healthcare. Healthcare provider shortages can be particularly severe, leaving residents without access to primary care and emergency services from physicians, nurses, and allied health professionals.

Aim/Objective: The purpose of the article is to propose a framework for developing …

Examining Health Disparities Among Lesbian, Gay, Bisexual, Transgender, And Queer/Questioning Adults In Davidson County, Tennessee, Samantha Anticuar

DNP Scholarly Projects

Background: Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals experience increased risks for health disparities and discrimination compared to non-LGBTQ individuals, yet there is limited research in southern populations. Purpose: The purpose of this scholarly project was to examine if LGBTQ individuals had increased health disparities compared to non-LGBTQ individuals in Davidson County, Tennessee (TN). Methods: A quasi-experimental design (N = 1,704) used the 2019 Nashville Community Health and Well-being Survey for analysis. Results: Findings suggested LGBTQ individuals had increased odds of not having health insurance (p = .009, adjusted odds: 6.84), poor mental health (p …

Addressing Hidden Barriers To Follow Up Healthcare: A Community Referral Pilot Project, Amber Williams

Doctor of Nursing Practice Projects

Objective: The project was aimed to reduce the number of participants lost to primary care follow-up following a mobile health unit screening event.

Design: A pilot study program screening tool implementation was utilized to address the hidden barriers of the Social Determinants of Health (SDoH) during a Winter 2021 event.

Sample: A group of 12 participants were screened during a mobile health unit event. Eight of the participants opted to be a part of the pilot study.

Measurements: A comparison ratio of Primary Care follow up was compared from the Winter of 2020 with Winter of 2021, where the screening …

Patients' Disclosure Of Sexual And Gender Minority Status: A Comparative, Multiple Case Study, Damon B. Cottrell

Nursing Theses and Dissertations

This work explores the healthcare and related experiences of sexual and gender minority (SGM) people. This population faces unique challenges in addressing their health needs. In the context of these challenges, the health outcomes are often poorer than those of heterosexuals. SGM subpopulations experience unique disparities making healthcare needs more complex and necessitating an understanding of SGMs’ being. Essential to addressing SGMs’ healthcare needs is the healthcare provider’s (HCP’s) knowledge of sexual and gender minority status. The first manuscript in this portfolio dissertation, Fostering Sexual and Gender Minority Status in Patients, provides an overview of the issues surrounding disclosure to …

Process Improvement To Improve Quality Measures In A Rural Primary Care Clinic, Lucille Yurko Vanderwoude

Doctoral Projects

Health disparities are differences in health that increase the amount of sickness in certain parts of the population, these inequalities in health are directly influenced by social, economic and environmental status (Healthy People 2020, 2008). Individuals living in poverty, violence, or disability have less opportunity for good healthcare and often have higher rates of chronic disease. Rural geographic locations additionally fall under this category (Healthy People 2020, 2008). These disparities can result from decreased exercise, violence in living situations, and unhealthy diet choices or options (CDC, 2018). Research has shown that health disparities increase with a reduction of individual’s income …

Consider The Person, Thao Vu

Regis University Student Publications (comprehensive collection)

Being culturally competent means being able to understand your own personal biases to avoid behaviors that may be considered discriminatory. In healthcare, it also means treating patients with respect and providing optimal care regardless of their background. If patients lack the care that they need or are provided with less than optimal care, then health care disparities arise, increasing the inequalities that are already present within the health care system. At the center of this care are the nurses who interact with patients the most during their clinical session. Thus, it is vital for nurses to be culturally competent and …

Addressing Barriers To Maternal Healthcare For Marshallese Islanders In Northwest Arkansas: An Internship Experience, Victoria Richardson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The Marshallese community is a rapidly growing population in Northwest Arkansas. Approximately 12,000 people migrated from the Marshall Islands and settled in the state of Arkansas due to the signing of the Compact of Free Association (COFA) in 1986. Although the population in Northwest Arkansas is experiencing rapid growth, there are significant health disparities that coincide with it. Due to vast cultural differences, language barriers, low economic status, and political barriers, the Marshallese community suffers from prenatal health inequalities and poor maternal and fetal outcomes, including low birth-weight infants, premature births, and increased infant mortality. During my internship, I provided …

Health Literacy Intervention For Low Income Uninsured Population, Laura Larson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Health literacy (HL) requires basic skills in writing, reading, numeracy, and communication all within a health context (Berkman et al., 2011). HL is a critical element for individuals to take an active role in managing their health. The National Assessment of Adult Literacy found only 12% of adults had a “proficient” HL level. Hispanics were found to be at greatest risk for lower HL than all other ethnic groups (Kutner, Greenberg, Jin, & Paulsen, 2006). Low HL can lead to poor health outcomes including: decreased utilization of preventative services, difficulty in managing chronic conditions, and increased disparities in access …

Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata

Walden Dissertations and Doctoral Studies

Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health …

Exploring The Narratives Of Black Male Nurses In Southeast Georgia: Implications For The Implementation Of Culturally Responsive Pedagogy In Nursing Curriculum, Celine M. Pfund

Electronic Theses and Dissertations

ABSTRACT

This dissertation inquiry explores the narratives of two Black male nurses in southeast Georgia. The framework for my research includes a variety of different theoretical components including works from both major nursing and curriculum studies scholars. The nursing workforce remains homogenized despite major recruiting. The intention of my research was to explore the experiences of Black male nurses to identify challenges, barriers, and systems of oppression that they may have encountered working in a profession dominated by White females in order to facilitate development of culturally responsive pedagogy in nursing. Methodologically, I mainly drew upon James Spradley’s work on …

Promoting Transgender Cultural Awareness And Sensitivity Through Education: It Starts With A Pronoun, Jacob Adkison

Doctor of Nursing Practice (DNP) Projects

Background: Health and social disparities affect the quality of life of transgender and gender nonconforming people in a negative manner as opposed to that of their cisgender counterparts (James et al., 2016). Gender discrimination, the lack of medical insurance, and a shortage of culturally competent providers contribute to some of the healthcare barriers in this population. The absence of supportive education for healthcare practitioners for providing culturally sensitive care impacts the transgender and gender nonconforming persons’ desire to seek routine health maintenance due to stigma, which can result in poor health outcomes (Bauer et al., 2009).

Methods: To help fill …

Effectiveness Of Cultural Competence Education In Baccalaureate Nursing, Sharon Kessler

Nursing (graduate) Student Scholarship

Health disparities based on race and socioeconomic status persist despite efforts to improve access to care. Culturally competent nurses play an important role in providing quality care and reducing health disparities. The American Association of Colleges of Nursing (AACN) has asked colleges to develop programs to prepare students to decrease health disparities, resulting in nursing programs working to increase cultural competence among students in response to the changing demographic makeup of this country. This paper reviewed and critically appraised current literature regarding methods baccalaureate programs use to develop culturally competent nurses. The evidence based practice question guiding this project was, …

Pursuing Equity In Diabetes Population, Aisha Rawlinson

Master's Projects and Capstones

Abstract

Background

Poor glycemic control (HbA1c >8) overtime leads to microvascular and macrovascular complications after the first and third years respectively, ultimately resulting in death after five years (Karter, 2016). Current Kaiser Permanente (KP) data stratified by race, ethnicity, age, and gender shows a significant disparity gap between Hispanics/Latino and Caucasian populations. The Pursuing IHI initiative is over a 2-year period completed at a microsystem that is focusing on health equity practices to reduce disparity gaps.

Project aim

KP Riverside, microsystem selected has a large population of Hispanic/Latino KP members, with focus on health equity. The project aim is to …

Cultural Beliefs, Language, And Ethnicity With Healthcare: Patient's Satisfaction, Lucy D. Delacruz-Gibb

All Electronic Theses and Dissertations

Background: The rising diversification of the U.S. population consists of 40 percent immigrants or first generation Americans (Huscup, 2010). This ethnic composition of the population poses great challenges for healthcare institutions and healthcare providers. This trend directly influences and transforms healthcare delivery; it strongly affects and guides health and nursing practices. Purpose: The purpose of this critical review of the literature is to investigate how patients’ varied cultural beliefs, language barriers, and/or ethnic backgrounds can affect perceived/real health treatments or outcomes; thereby influencing the patients’ satisfaction with healthcare providers and facilities. Results: Following the systematic review of the literature, twenty-four …

Implementation Of A Wellness Program To Address Health Disparities In A Vulnerable Population, Patricia Clark Pappas

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was to implement a Wellness program to address the health disparities in a vulnerable population. The population targeted was a local population that was served at a mental health facility for socioeconomically disadvantaged. The program focused on improving knowledge of cardiovascular health, empowerment and communication skills. Significance: The significance of the project is the improvement in ones wellness by provision of education, empowerment and communication skills. The attaining of these skills can translate into other areas of wellness and improved health outcomes. Populations at risk due to socioeconomic and racial differences can …

Lgbt Advocacy: One Leader's Journey Through Fear To Transcendence, Paula Suffrins

Theses and Graduate Projects

The LGBT population experiences healthcare disparities at higher rates than their heterosexual counterparts. Fear among this population prevents them from seeking health care. Nurses can be influential in addressing this fear and decreasing healthcare disparities within the LGBT population. However, LGBT content offered in nursing programs is not adequately preparing students to care for this specific population in a culturally sensitive manner. Healthcare organizations lack LGBT content in orientation programs as well. Transformational nursing leaders can initiate and support the effort to create a safe and welcoming environment for the LGBT population where healthcare can be delivered by culturally sensitive …

An Analysis Of Interpreter-Mediated Healthcare Interactions, Robin Dawson Estrada

Theses and Dissertations

The content and quality of communication between nurse practitioners and patients in primary care encounters contributes to diagnostic decision making, the provision of culturally appropriate interventions, and ultimately may impact health outcomes. In caring for patients with limited English proficiency, the addition of language discordance increases the complexity of the interaction and communication processes and the potential for disparate health outcomes. Most prior research on interpreter-mediated healthcare interactions has focused on accuracy, cost, satisfaction, and role enactment, but there is a lack of systematic research examining the actual interaction processes within the context of primary care clinic visits.

The aim …

Self-Care Agency And Self-Care Practice Of Adult African Americans With Type 2 Diabetes, Martha Eddings

Nursing Theses and Capstone Projects

The purpose of the study was to identify and examine the concepts of self-care agency and self-care practice of African American adults diagnosed with type 2 diabetes, living in the local community. The research questions addressed were: 1) What is the self-care agency of adult African Americans diagnosed with type 2 diabetes? 2) What is the self-care practice of adult African Americans diagnosed with type 2 diabetes? 3) Is there a relationship between self-care agency and self-care practice in adult African Americans diagnosed with type 2 diabetes? The Denyes Self-Care Agency Instrument (DSCAI-90) and the Denyes Self-Care Practice Instrument (DSCPI-90) …

Developing A Community Clinic To Address The Health Needs As Experienced By A Small Rural Village In Sierra Leone, Doris K. Acton

Theses and Graduate Projects

Developing countries experience a disproportionate amount of health care inequities due to extreme poverty, lack of education, minimal resources and marginalization from health care services. Additionally, barriers such as access, availability and affordability prevent people from seeking care. Development of community based clinics can help to address the health disparities that the people of these countries often experience. Utilizing Madeleine Leininger's Culture Care Theory and the Sunrise Enabler provide a framework on which to develop clinics and health care programs in ways that are culturally congruent and acceptable. This paper addresses the health needs of Manonkoh, a small village in …