Medicine and Health Sciences Commons^™

Implementation Of A Peer Support Program To Increase Resilience In Nurse Managers In Acute Care Hospitals: A Pilot Study, Juana Castillo

Doctoral Projects

Background: Nurse managers are at risk for experiencing stress and burnout. The peer support program was implemented to increase resilience among nurse managers.
Methods: A one-group pretest and posttest design was employed to examine the impact of peer support on nurse manager resilience. The nurse managers participated in bi-weekly 30-minute peer sessions over 12 weeks. The Connor-Davidson Resilience Scale was utilized prior to and following the intervention along with demographic and satisfaction surveys.
Results: There were six nurse managers who participated in the peer support program; however, only four completed both the pre- and post-survey. The peer support program intervention …

Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus

Doctoral Projects

Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …

Health Promotion Module For Migrant Youth Adults In Obesity Prevention: A Pilot Project, James Chongsu Wong

Doctoral Projects

The obesity epidemic continues to worsen. It is estimated there are over one half billion adults worldwide struggling with obesity. In the United States of America, 42% of the adults and over 15 million children are obese. Obesity leads to a myriad of other chronic diseases such as diabetes mellitus, hypertension, and hyperlipidemia. With an annual spending exceeding 173 billion dollars, obesity not only has a negative impact on quality of life but also a huge economic impact on the health care system.
This quality improvement project utilized 4 educational modules as intervention and measured the mean changes using a …

Implementing High-Intensity Trauma-Informed Sexual Behavior Risk Reduction In Justice-Involved Women, Lakisha M. Holton

Doctoral Projects

Sexually transmitted infections continue to be a source of significant morbidity in people with a history of incarceration, particularly women. Justice-involved women are at exceptionally high risk of long-lasting and severe health consequences of contracting an STI. This evidence-based practice implementation project used a repeated measures design to compare sexually transmitted infection knowledge acquisition and condom use self-efficacy in a group of incarcerated women before, immediately after, and three weeks following participation in the Safer Sex Self-Efficacy Workshop. Of the participants (N= 21), 100% demonstrated a significant increase in sexually transmitted infection knowledge and condom use self-efficacy between pre- and …

Asthma Care By Unlicensed Personnel In The Elementary School Setting: A Training Program, Teresa Eligio

Doctoral Projects

This Quality Improvement project (QI) aims to improve the competence and confidence of unlicensed school health staff in identifying asthma symptoms, reading an asthma action plan, asthma care, emergency response, medication delivery tools, and trigger reduction in the school setting. The QI project transpired in an Elementary School District in Los Angeles County, CA. The Project Manager, an asthma instructor trained by the American Lung Association, provided evidence-based Asthma-Basics training for health clerks (HCs), substitute health clerks (SHCs), licensed vocational nurse health clerks (LVN HCs), school office coordinators (SOCs), school office attendance clerks (SOAs), and substitute school office staff (SDO). …

By Utilizing Technology Can Nursing Students Gain More Confidence And Decrease Anxiety When Communicating With Chronically Ill Patients About Their Sexual Relationship?, Sheri Rickman Patrick, Alice Butzlaff

Faculty Research, Scholarly, and Creative Activity

Introduction
Effective communication is an essential part of nursing care. Nurses need to effectively communicate with patients, families, providers and staff. The purpose of this study was to show how the use of technology (i.e., video conferencing on an electronic device) could assist nursing students to gain more confidence and reduce anxiety when discussing difficult topics such as sexual intimacy.
Methods
Pre-licensure nursing students were recruited to participate as part of regular class activities. A pre- and post-survey asking about their confidence and anxiety in communicating with patients was completed; then subjects were randomly placed into groups of 4 to …

Mindful Matters: Addressing Barriers To Classroom-Based Mindfulness, Kirsten Munk

Doctoral Projects

A growing body of research suggests that incorporating classroom-based mindfulness interventions in elementary schools is associated with improvements in student behavior, self-regulation, and measures of mental health. However, the adoption of teacher-led mindfulness programs in California’s public schools has not been widely embraced. This doctoral project explored the impact of an educational intervention on pre-service teachers’ perceptions, attitudes, and intentions to implement mindfulness interventions in their classrooms. A brief educational intervention and website resource were provided to multidisciplinary teaching credential students in a 2-year graduate credential program. Participants completed a pre- and post-intervention survey to evaluate their intentions to implement …

Nurse Practitioners’ Perceptions Of Telehealth Behaviors, Michelle Austin

Doctoral Projects

Problem: NP’s must be proficient in the behaviors that are required for a successful patient encounter to provide the full benefit of nurse practitioner (NP) telehealth. Consequently, it is imperative for NPs to understand telehealth etiquette behaviors which include the technical and non-technical skills that are necessary for an effective NP-patient patient telehealth encounter (Haney, Kott & Fowler, 2015). Telehealth has been incorporated into healthcare delivery and its use is expanding. In the United States, it is predicted to be used by seven million patients in 2020 (US Department of Health and Human Services, 2018). Appropriate access to health care …

Willingess To Use Telehealth For Diabetes Management In The Rural Healthcare Setting, Andrew Kim

Doctoral Projects

Diabetes is a disease that has far reaching physically and financially consequences. This disease has shown to increase morbidity and mortality, along with increasing overall healthcare costs. Optimal management of diabetes may require a multidisciplinary approach across the span of multiple encounters with the diabetic patient. Considering the nature of diabetes, integration of telehealth has the opportunity to improve diabetes management by improving healthcare outcomes, along with potential cost savings. However, the use of novel technology like telehealth is only as useful if patients are willing to use it. Thus, this survey aimed to determining whether patients within a rural …

The Mental Health Experience Among Parents Of Children With Autism, Thao Tran

Doctoral Projects

Parents of children diagnosed with autism spectrum disorder (ASD) face challenges, stress, and mental health issues than parents of children without autism. Mental health experience of parents in underserved communities are not adequately studied. This qualitative study used a phenomenological approach to understand the mental health experience of eight parent caregivers residing in San Joaquin Valley, California. All parents reported the journey was stressful but not all parents described the point when they received the diagnosis as being more stressful than before and after the ASD diagnosis. Parents’ responses to the semi-structured interview that assesses for the degree of ambiguous …

Exploring Ways To Improve Healthcare Access For The Homeless Population In Merced County, Stella Nwasoka Adesokan

Doctoral Projects

Homelessness is a societal dilemma that affects people in the United States and around the globe. Homelessness relates to poor health conditions that affect the living conditions of individuals (Institute for Urban Initiatives, 2018). Chronic and acute illnesses are rampant in this group, most of these illnesses are treatable but accessing healthcare poses a challenge for this vulnerable population. Homeless persons are often unable to access healthcare due to fear and denial of ill health, difficulty in communicating health needs, and low self-esteem (Lamb & Joels, 2014).

In the study, questionnaires were administered to 25 homeless individuals through random sampling. …

Barriers In Health Care In Hmong Men And Women With Cardiac Diseases, Ying Thao

Doctoral Projects

Lauver’s theory of care seeking behaviors is applied to identify perceived barriers to accessing healthcare in Hmong men and women that may influence care seeking behaviors. The purpose of this study is to identify barriers in accessing health care among Hmong men and women ages 50 to 80 with cardiovascular heart disease (CHD) and risk factors for CHD (e.g., diabetes, hyperlipidemia, and hypertension). A quantitative descriptive analysis was used to look at demographic characteristics while a multiple regression analysis was used to statistically compare correlations between barriers to care, risk factors for CHD, sex, and access to health care. The …

Follow-Up Among Homeless Patients At San Francisco General Hospital: Examining The Social Determinants Of Health, Robert Gnat

Doctoral Projects

The San Francisco General Hospital emergency department has a high occurrence of homeless patients that are lost to follow-up after discharge. This Doctor of Nursing Practice project conducted a survey to evaluate the social determinants of health among this population and how they influence the participant’s ability to follow-up. This is the first phase of a three-phase project involving assessment and evaluation. The second and third phases of this project will center on intervention and re-evaluation after intervention. The survey was administered to eligible participants who presented to the emergency department at San Francisco General Hospital. Fifty participants were surveyed …

Is There A Relationship Between Limited English Proficiency (Lep), Medication Adherence Behaviors, And Adverse Asthma Outcomes In Hispanic Adults With Moderate To Severe Persistent Asthma?, Archana Kartik Chandra

Doctoral Projects

The effects of LEP are well documented in the literature. LEP decreases medication adherence, causes ineffective communication between patients and providers, and reduces health outcomes. Asthma is known to be misdiagnosed and under-treated in Hispanic adults. There are discrepancies in the literature about the effects of LEP in Hispanic adults with persistent asthma.

The purpose of this study was to determine if the presence of LEP is associated with medication adherence behaviors and adverse asthma outcomes in Hispanic adults with moderate to severe persistent asthma. Hispanic adults with LEP were assessed for asthma outcomes and medication adherence behaviors.

The results …

Can Using A Smartphone Application Improve The Ability Of Law Enforcement Officers To Recognize Commercially Sexually Exploited Children And Report Them To Child Welfare Authorities?, Sheree Goldman

Doctoral Projects

The commercial sexual exploitation of children (CSEC) is a crime of abuse that is frequently unrecognized because mandated reporters may be unfamiliar with the indicators. Commercially sexually exploited minors participate in sex acts in exchange for money, goods, or services. At least 200,000 American children are believed to be victims of this crime each year (County Welfare Director Association of California, 2015). Victims often go undiscovered and experience significant health issues. A public health model is used to explain the context of victimization and the need for interdisciplinary collaboration to discover victims and connect them with needed services. A randomized …

Evidence-Based Study Of Medication Compliance Project In Hiv Prevention Using Pre-Exposure Prophylaxis (Prep) Antivirals For Hiv-Negative Males, Ming-Chun Ho

Doctoral Projects

In 2012, emtricitabine/tenofovir was the only Food and Drug Administration-approved medication for pre-exposure prophylaxis (PrEP) used in human immunodeficiency virus (HIV) prevention. To date, there is little research on open-label and mixed-payer characteristics supporting medication compliance of men who have sex with men (MSM). The purpose of this research was to describe individual demographic variables associated with PrEP medication adherence and to examine the effect of a follow-up phone call from a nurse once a month for 3 months. A total of 30 MSM were recruited and data were collected using a demographic questionnaire, medication adherence tool and follow-up phone …

Adolescent Sexual Health: Provider Evaluation Of A Sexual History Tool At A School-Based Health Clinic, Gillian Marie Williams

Doctoral Projects

There is a growing concern within the United States in regard to sexual behavior within our adolescent population. Sexually transmitted infections (STIs) have always been a concern, however, there has been a steady increase since 2014 in the three nationally reportable diseases of chlamydia, gonorrhea, and syphilis. According to the CDC (2017), 15-24 years old account for half of all the new STI s. There is a need to provide more sexual health to adolescents during their health visits. It is also imperative to understand the beliefs and attitudes of providers with providing these types of exams and asking questions …

Sexually Transmitted Infection Risk Reduction For College Students, Mary Kathryn Dowling

Doctoral Projects

University students have been assessed through many sexual health lenses, but there is a paucity of research on the sexual health of community college students. This population may provide good access to at-risk youth, and opportunity to reverse steep climbs in sexually transmitted infection (STI) rates. This research project pilot tests a theory-based intervention employing social facilitation to reduce STI risk among college students. Fifty students were recruited from Human Sexuality courses to participate in a 60-minute workshop. Pre- and post-testing measured for change in STI knowledge, attitude towards safer sex, and self-efficacy for engaging in safer sex practices.

A …

School Nurses’ Experience Of Barriers To Care In Children With Type 1 Diabetes, Eden Joseph Donahue

Doctoral Projects

Purpose: The purpose of the study was to gather data on the lived-experience of providing and coordinating type 1 diabetes care in the school setting from school nurses who practice in California. Methodology: A descriptive phenomenological qualitative study design was used to collect data through structured interviews with 13 school nurses. Descriptive coding was used to analyze the interview data. Findings: School nurses face multiple barriers to care when providing type 1 diabetes care in the school setting. The three major themes school nurses encountered were difficulty with care coordination, communication, and parents.

Prevalence And Prevention Of Diabetes In School Age Children: A Parent Education Module, Christine Mary Whitmyer

Doctoral Projects

The Center for Disease Control reports that there continues to be an increasing number of children being diagnosed with childhood-onset Type Two Diabetes Mellitus (T2DM). The recommendation is to provide education to parents regarding the risks and possible risk factors of T2DM, and strategies to prevent and treat these risk factors (Center for Disease Control [CDC], 2014). Educating parents of school age children on T2DM risk factors, and prevention practices may help to slow down this rising number of new cases. The Aim is to provide educational modules that may increase knowledge, which could in-turn change behavior, that may prevent …

Sexually Transmitted Infection Prevention In 18 To 24-Year-Old Heterosexual Men: Pilot Study, Susan P. Mckeefrey

Doctoral Projects

The CDC reported that there were over 20 million cases in the United States and half affected young adults, 15 to 25-year olds. Strategies STD prevention have been developed by the CDC but does not include avoiding alcohol or other similar agents in the context of a sexual encounter. The purpose of this study was to assess the effectiveness of STD prevention education intervention by improving Condom Use Self-Efficacy in heterosexually 18 to 24-year old men. It was hypothesized self-efficacy would improve with a face-to-face brief educational intervention. A quasi-experimental, pre-/post-test design with simple randomization of subjects into control and …

African American Men And Ostrich Behavior, Debbie Slack-Gay

Doctoral Projects

This project explores why African American men choose Ostrich Behavior when it comes to health care prevention and maintenance as related to hypertension. The population was African American men, ages18–80, in Northern California. Men were recruited while getting a haircut or waiting for one or after church services. Blood pressure readings were taken and a health questionnaire was administered. The results show that even if hypertension is known, men ages 18–45 go to fewer office visits than African American men in other age groups, and older men tend to seek medical care and take medication if prescribed.

An Exploration Of Social Capital Among Nurses In The Ambulatory Setting, Anna Lutz, Tamara Mckinnon

Doctoral Projects

Bullying and lateral violence are a sadly, common phenomena among nurses. While this issue has been examined within the inpatient, acute setting, it has not been widely researched in the ambulatory setting. This concept is usually looked at from a negative standpoint, looking at the levels of lateral violence. The purpose of this research study was done to explore the levels of social capital, also known as positive peer support, among nurses in the ambulatory setting. The participants of the study were 39 registered nurses from a public health department and an embedded care management department. The tool used was …

Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy

Doctoral Projects

This descriptive study examined undiagnosed depression in the elderly and how it affects the elderly from retaining healthcare education. It is estimated by 2029, 20% of the United States population will be age 65 and older (Colby & Ortman, 2014). Depression in the elderly who have chronic diseases, is estimated to be undiagnosed up to 40% (Chaoyang et al., 2009). A hallmark symptom of depression is the inability to concentrate. It is unknown if undiagnosed depression will affect the older adult from retaining pertinent healthcare education. The 30 point Geriatric Depression Scale (GDS) was administered to a class of elderly …

The Effectiveness Of California Assembly Bill 2109: Personal Belief Exemptions For Kindergarten Immunizations, Lilli Shizuka Goishi-Bessey

Doctoral Projects

The numbers of vaccine preventable diseases (VPDs) in the United States has declined with the development, administration, and effectiveness of vaccines during the 1970s and 1980s. As the eminent threat of VPDs to the public began to wane, parents started questioning the safety and necessity of vaccines. When parents were given the option of selecting personal belief exemption (PBE) waivers for state mandated immunizations for their incoming kindergarten children, an increase in PBEs and the number of VPD outbreaks began to occur. To counter the growing trend of PBEs, and to prevent outbreaks of VPDs in school settings and communities, …

A Phenomenological Assessment Of Factors That Affect Medication Adherence Among Hypertensive Nigerian Immigrants, Beulah Iroegbu

Doctoral Projects

This qualitative study explored the perceptions that affect medication adherence among hypertensive Nigerian immigrants in Sacramento, California. The research questions focused on factors that influenced the adherence to hypertension medication; specifically, how the sample population explained the cause of hypertension and whether culture and religion impacted the cause and management of hypertension. A phenomenological approach was used to understand perceptions about medication adherence. A predefined group of 9 acted as a purposive sample and was given semi-structured individual interviews. Qualitative data analysis of the interviews was performed using Colaizzi's 7-step method. Results from the study found the cause of hypertension …

Pediatric Nurse Practitioner Home Visitation Is Associated With A Decrease In Home Care And Healthcare Utilization Errors In High Risk Infants, Rupalee Patel

Doctoral Projects

The Santa Clara Valley Health and Hospital System’s (SCVHHS) Babies Reaching Improved Development and Growth in their Environment (BRIDGE) program was developed in 2011 to optimize high risk infants' care transition from Neonatal Intensive Care Unit (NICU) to home. In addition to hospital discharge teaching and public health nursing efforts, NICU infants need further in home support given their medical vulnerability after discharge. The objectives of the SCVHHS BRIDGE program are to provide caregiver interventions to minimize home care errors after NICU discharge and to optimize health care access and utilization across the transition of care. SCVHHS NICU infants at …

Attention Deficit Hyperactivity Disorder And Mindfulness Practice In Children And Adolescents: A Comprehensive Review Of Evidence-Based Research, Donna Nikander

Doctoral Projects

Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental illness in the United States among male and female children and adolescents between the ages of 3 and 17. The emerging fields of neurobiology and neuroimaging have proposed a relationship between mindfulness meditation therapies—initially referred to as mindfulness-based stress reduction (MBSR) and now simply known as mindfulness—and improvements in attention and self-regulation, two major problem areas for ADHD sufferers. Furthermore, recent studies suggest that mindfulness therapies may be effective in reducing symptoms of ADHD in children and adolescents. The purpose of this paper is to review, analyze and synthesize the …

Sexually Transmitted Disease Education And Effects On Condom Use In College Students, Patricia Alvarez

Doctoral Projects

In the United States, nearly 50% of the sexually transmitted diseases (STDs) reported each year occur in adolescents and young adults ages 15-24. An IRB approved, exploratory mix method research study was conducted in a California Community College to investigate participants' opinions on STD education tools, effectiveness, and to rank preferred instructional methods used in 51h-12'h grades. One hundred and thirteen students participated and reported use of variety of educational tools with the lecture technique selected by almost 80% surveyed. Demonstration of condom application had highest percent ranked as number one for the preferred educational tool; yet had the least …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …