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Assessing The Types Of Juvenile Detention Medical Issues: A Focus On Florida, De’Angelo Dean Feb 2024

Assessing The Types Of Juvenile Detention Medical Issues: A Focus On Florida, De’Angelo Dean

MUSC Theses and Dissertations

The justice system for young people in the United States has been a source of worry as more people acknowledge the possible adverse outcomes of involvement in the justice system during adolescence. Involvement with law enforcement can lead to various difficulties for young people, such as heightened susceptibility to psychological problems, interruptions in their education, and reduced prospects for achievement in the future. Hence, it is crucial to understand the interplays between the health care for juveniles referred by courts or law enforcement for hospital care to identify opportunities for process and outcome improvements. The interaction between juveniles and the …


Incorporation Of Nutrition Education With Medication Injection To Sustain Weight Loss, Julia Calvelo Jan 2024

Incorporation Of Nutrition Education With Medication Injection To Sustain Weight Loss, Julia Calvelo

Nursing | Senior Theses

Background: Obesity is a widespread occurrence linked to comorbidities. Weight loss and maintenance is crucial to sustain existing health conditions and reduce risk of chronic diseases.

Lack of maintained weight loss is associated with poor education on nutrition, diet, and physical activity literacy. Objective: The purpose of this quantitative experimental study is to determine the efficacy of nutrition education among medication injection to sustain weight loss throughout treatment. It aims to promote comprehension of the aspects of nutrition, dietary habits, and physical education to not only sustain weight loss, but to understand the significance of how these elements contribute to …


From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell Dec 2023

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …


Traditional And Emerging Modifiable Lifestyle Risk Behaviors For Non-Communicable Diseases In A Sample Of Hispanic/Latino American Adolescents Living In The U.S.-Mexico Border Region, Silvia Salinas Lopez Dec 2023

Traditional And Emerging Modifiable Lifestyle Risk Behaviors For Non-Communicable Diseases In A Sample Of Hispanic/Latino American Adolescents Living In The U.S.-Mexico Border Region, Silvia Salinas Lopez

Open Access Theses & Dissertations

Background: Non-communicable diseases (NCDs) pose a significant global health threat, with modifiable lifestyle risk behaviors (mLRBs) contributing substantially to their onset. This study examined traditional and emerging mLRBs and their distribution on cross-sectional health outcomes among Hispanic/Latino in-school adolescents living on the U.S.-Mexico border. Methods: This secondary data analysis used information from the cross-sectional 2019 El Paso YHBS obtained through online surveys. The secondary data analyzed the prevalence, clustering, and co-occurrence of mLRBs of 539 Hispanic/Latino high school students. Results were compared to mLRBs findings corresponding to Hispanic/Latino adolescents who participated in the national and state 2019 CDC YRBSS. An …


Comparison Of Physical Activity Levels Among School-Age Adolescents In The Rural And Urban Areas Of District Swat Kpk, Pakistan- An Analytical Cross-Sectional Study, Imran Uddin Nov 2023

Comparison Of Physical Activity Levels Among School-Age Adolescents In The Rural And Urban Areas Of District Swat Kpk, Pakistan- An Analytical Cross-Sectional Study, Imran Uddin

Theses & Dissertations

Background: Obesity and overweight represent significant global public health concerns. Young adolescents are in particular increasingly experiencing obesity and overweight due to their sedentary lifestyles, excessive electronic media use, and lack of physical activity (PA). This trend is linked to the development of non-communicable diseases in later life. Moreover, data regarding the lack of PA is available in Pakistan, but a gap exists in the comparative analysis of physical activity levels between rural and urban adolescents. Rural and urban areas exhibit distinctions in both geographical settings and technological advancements, potentially influencing the PA levels of their respective inhabitants.
Purpose: The …


Supervisor Workplace Violence Against Young Workers By Victim's Race/Ethnicity, Camryn Lopez May 2023

Supervisor Workplace Violence Against Young Workers By Victim's Race/Ethnicity, Camryn Lopez

Boise State University Theses and Dissertations

Working is often seen as an integral aspect of growing up in the United States. Due to the increased desire for independence and financial gain, many adolescents decide to pursue the expansion of their job skills by entering the labor force. Adolescents crave financial independence and freedom. However, many are unaware of the risks that accompany working. The perpetrators of adolescent workplace violence are generally thought to be customers or coworkers. But what if it was the supervisor?

The main objective of the study is to determine whether abusive supervision of young workers differs depending on the worker’s race/ethnicity. Using …


Comprehensive Literature Review: Assessing The Impact Of Covid-19 Policies, School Closures And Social Distancing, On The Mental Health Of School Age Children, Fatuma A. Hassan May 2023

Comprehensive Literature Review: Assessing The Impact Of Covid-19 Policies, School Closures And Social Distancing, On The Mental Health Of School Age Children, Fatuma A. Hassan

Capstone Experience

Mental health is vital to the well-being of all individuals, especially children. COVID-19 unveiled a significant public health issue with poor mental health during the pandemic. There is limited literature about the mental health implications of COVID-19 policies for children and adolescents and preventive strategies for future pandemics. This comprehensive literature review seeks to further investigate the mental health impacts of school shutdowns and social distancing, which were nonpharmaceutical strategies, on school-aged children, 5-18 years old, and propose recommendations for public health officials to mitigate the mental health impacts for future pandemics. Additionally, the review aims to highlight the potential …


Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew Jan 2023

Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a major public health problem in the United States. Adolescents are a high majority of these cases, with African American adolescents being affected disproportionally. Previous research has shown that risky sexual behaviors, such as non-condom use, multiple sexual partners, early initiation of sexual intercourse, and alcohol or marijuana use before sexual intercourse put adolescents at a higher risk of contracting an STI when they are sexually active. These behaviors can be observed through the theoretical framework of the problem behavior theory that describes the constructs of why individuals engage certain behaviors. How alcohol and drug …


Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew Jan 2023

Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a major public health problem in the United States. Adolescents are a high majority of these cases, with African American adolescents being affected disproportionally. Previous research has shown that risky sexual behaviors, such as non-condom use, multiple sexual partners, early initiation of sexual intercourse, and alcohol or marijuana use before sexual intercourse put adolescents at a higher risk of contracting an STI when they are sexually active. These behaviors can be observed through the theoretical framework of the problem behavior theory that describes the constructs of why individuals engage certain behaviors. How alcohol and drug …


Nutrition Facts Label Use Among U.S. Adolescents, Jennifer Beth Mandelbaum Oct 2022

Nutrition Facts Label Use Among U.S. Adolescents, Jennifer Beth Mandelbaum

Theses and Dissertations

Despite the promise of Nutrition Facts label (NFL) use as a population-level intervention with broad reach, few studies have examined determinants of adolescents’ NFL use, and how this label use may be associated with nutrition behaviors. This study used data from the International Food Policy Study, an online cross-sectional survey of trends in dietary patterns and policy-relevant behaviors in the U.S. and five other countries. First, this study examined 1) whether NFL use was associated with healthy eating efforts and 2) whether there were sociodemographic differences in NFL use among U.S. adolescents. Results demonstrated that NFL use was positively associated …


Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz Aug 2022

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …


Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz Aug 2022

Ask Your Doctor About: Prescribing Activism For Eco-Anxiety In Adolescents, Lexi Nutkiewicz

Master's Projects and Capstones

Climate change is an ongoing public health crisis. Efforts to protect future generations' physical and mental health are more urgent than ever. Youth, in particular, are experiencing eco-anxiety, a specific form of anxiety relating to stress or distress caused by environmental changes and one’s knowledge of them due to the climate crisis. This scoping review provides a better understanding of the value of youth climate change activism as a strategy to mitigate eco-anxiety. This review evaluates the current definitions of eco-anxiety, the risk factors for eco-anxiety among adolescents, and considers the benefits and drawbacks of youth activism. To identify relevant …


Save The Date: An Analysis Of Interventions On Teen Dating Violence, Elizabeth Maestretti Aug 2022

Save The Date: An Analysis Of Interventions On Teen Dating Violence, Elizabeth Maestretti

Master's Projects and Capstones

Domestic violence or interpersonal violence (IPV) is a serious public health issue in the United States. IPV is commonly considered to be an issue that occurs in adult relationships. However, most victims of IPV first experience some form of IPV during adolescence, which is known as teen dating violence (TDV). In the United States, TDV impacts about 26% of female and 15% of male adolescents. In Southern California (Orange County) approximately two thirds of adolescents have experienced some form of TDV. This paper examined the literature on existing interventions and strategies which focused on TDV prevention at individual, interpersonal, community/organizational, …


Practicing Trauma-Informed Care In Nursing For A Better Outcome In Hospitalized Adolescents With Adverse Childhood Experiences And Trauma, Allysa Mia Fabricante May 2022

Practicing Trauma-Informed Care In Nursing For A Better Outcome In Hospitalized Adolescents With Adverse Childhood Experiences And Trauma, Allysa Mia Fabricante

Nursing | Senior Theses

As nurses we want to give our patients the best care. That is why trauma-informed care (TIC) is important to include into nursing practice. TIC is a fairly new idea that addresses a patient's whole past and present life. Incorporating it into nursing practice can benefit patients who have adverse childhood experiences and trauma. Adverse Childhood Experiences (ACEs) are traumatic events that occur to a person starting from birth to 17 years old. In a hospital setting an adolescent patient can be triggered if ACEs and trauma is not properly addressed. The long-term effects of ACEs can affect adolescents into …


The Age Of E-Cigarette Initiation And Association With Frequency Of Use And Risk Of Combustible Tobacco Cigarette Smoking Initiation, Andy Hu Apr 2022

The Age Of E-Cigarette Initiation And Association With Frequency Of Use And Risk Of Combustible Tobacco Cigarette Smoking Initiation, Andy Hu

Senior Theses

Background - Studies have shown that electronic nicotine delivery systems (ENDS) are unsafe for consumption. However, the prevalence of e-cigarette use among adolescents and young adults continues to increase, which is being addressed by research. Little attention has been paid to the effects of earlier age of ENDS initiation.

Purpose - This paper examined published research studies on the topic of the age of initiation of e-cigarette use in relation to 1) frequency of e-cigarette use and 2) risk of combustible tobacco cigarette smoking initiation. This research tested the hypothesis that an earlier age of e-cigarette initiation was associated with …


Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett Jan 2022

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …


Correlates Of Risky Sexual Behaviors Among African American Females In Juvenile Detention Centers, Eghosa E. Asemota Jan 2022

Correlates Of Risky Sexual Behaviors Among African American Females In Juvenile Detention Centers, Eghosa E. Asemota

Electronic Theses and Dissertations

Introduction: In comparison to other demographics, research shows that African American female adolescents are over-represented in the United States Juvenile Justice System. Studies in this vulnerable population demonstrate higher rates of engagement in unsafe sex, and its attendant negative consequences of HIV infections, sexually transmitted diseases, and mistimed pregnancies. There is a paucity of studies that have specifically examined risky sexual behaviors amongst African American females in Juvenile Detention Centers. Objective: The aim of this study is to assess the relationship between the individual, family, peer, and societal factors, and engagement in risky sex among Black female detainees in Juvenile …


The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal Dec 2021

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …


Serving Our Students: Evidence-Based Sex Education Policies And Practices Needed In Ohio, Lily Mckenzie Rosenberg Dec 2021

Serving Our Students: Evidence-Based Sex Education Policies And Practices Needed In Ohio, Lily Mckenzie Rosenberg

Honors Projects

Ohio has very minimal state-wide sex education laws, requiring only venereal disease education that has many similarities with abstinence-only education. Abstinence-only education has been shown to be ineffective in delaying first sex and lowering teen STDs, pregnancy, and birth rates. When students receive ineffective (or no) sex education it can impact them in many ways, leaving them unprepared for sexual lives as adults. To analyze the state of sex education in Ohio, this paper will look at sex education throughout Ohio both in law and in practice. I will then explore the impact of these minimal sex education laws on …


Translation And Validation Of The Spanish Version Of The Quality Of Life Inventory For Adolescents (Qolie-Ad-48), Perla Michelle Martinez Aug 2021

Translation And Validation Of The Spanish Version Of The Quality Of Life Inventory For Adolescents (Qolie-Ad-48), Perla Michelle Martinez

Open Access Theses & Dissertations

Background: In 1999, an instrument was developed to assess quality of life (QoL) among adolescences with epilepsy. To our knowledge there is not a validated Spanish version of this questionnaire. There is a gap in the literature about QoL and epilepsy among speaking Spanish populations. Objectives: 1) To conduct an English-Spanish translation of the QOLIE-AD-48; 2) to evaluate the reliability of the Spanish version of the QoLIE-AD-48; and 3) to assess the validity of the Spanish version of the QoLIE-AD-48. Method: Phase 1 translation: Methods followed the published work of Sousa and Rojjanasrirat (2010). Phase 2 Pilot study: the sample …


Intimate Partner Violence Education For High School Students, Morgan Foster Jul 2021

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …


A Quality Improvement Initiative: Combination Oral Contraception And Counseling For Sexually Active Adolescent Girls 12-18 Years Old, Angelica Del Toro Jul 2021

A Quality Improvement Initiative: Combination Oral Contraception And Counseling For Sexually Active Adolescent Girls 12-18 Years Old, Angelica Del Toro

Cohort IX

According to the 2016 “U.S. Selected Practice Recommendations for Contraceptive Use” and the “U.S. Medical Eligibility Criteria for Contraceptive Use,” published by the Centers for Disease Control (CDC) and the World Health Organization (WHO), sexually active adolescents benefit from oral contraception and counseling from their primary care practitioners, as they already have an existing relationship. As a family nurse practitioner, I could provide an initial assessment and prescribe the appropriate contraceptive instead of referring them to a gynecologist.

I learned this in my practice during a 10-day reflective practice log. After a literature review and several supporting articles, I received …


The Relationships Between Stress, Psychosocial Resources, And Mental Health And Adherence Outcomes Among Perinatally Hiv-Infected Adolescents In South Africa, Thabani Nyoni May 2021

The Relationships Between Stress, Psychosocial Resources, And Mental Health And Adherence Outcomes Among Perinatally Hiv-Infected Adolescents In South Africa, Thabani Nyoni

Brown School Theses and Dissertations

Adolescents living with perinatally acquired HIV (APHs) in sub-Saharan Africa (SSA) constitute a significant population group that is experiencing poor HIV treatment outcomes (CIPHER Global Cohort Collaboration, 2018). Compared to younger children and older adults within the SSA sub-region, APHs experience poorer health outcomes, including retention in care, virologic treatment failure, and mortality rates (Anderson et al., 2019). Among countries in the SSA sub-region, South Africa has 360,000 adolescents living with HIV (ages 10-19), a disproportionate burden, accounting for 20% of the global adolescents living with HIV (UNAIDS, 2019a). The public health costs of suboptimal antiretroviral treatment (ART) adherence in …


The Effect Of Race, Provider-Location Type, And Region On Adolescent Hpv Vaccination, Erica Sade Hunter Jan 2021

The Effect Of Race, Provider-Location Type, And Region On Adolescent Hpv Vaccination, Erica Sade Hunter

Walden Dissertations and Doctoral Studies

Studies have been conducted on various factors and their effect on human papillomavirus (HPV) vaccination uptake amongst adolescents. However, these studies typically point to communication factors and provider recommendations as having a significant effect on HPV vaccination uptake, ultimately leading to the need for more information on other factors that may increase HPV vaccination amongst adolescents. The purpose of this quantitative cross-sectional study was to determine if race, provider-location type, and region of the United States have a statistically significant effect on HPV uptake amongst adolescents. The 2018 National Immunization Survey (NIS) was used, and 34,980 participants were included in …


The Impact Of Social Media On Teenage Females Self-Esteem, Amanda C. Perkovich Jan 2021

The Impact Of Social Media On Teenage Females Self-Esteem, Amanda C. Perkovich

All Graduate Theses, Dissertations, and Other Capstone Projects

Social media has become the way we connect with the world. Social networking sites, including Facebook, Instagram, Snapchat, Twitter and TikTok, allow users to share intimate details of their lives, upload photographs, initiate and maintain relationships, plan social gatherings, observe the lives of others and express beliefs, values and emotions. In the last ten years, numerous articles have focused on the relationship between social media use and mental health however, very few studies have concentrated on self-esteem, especially in teenage females. The purpose of this literature review is to explore the associations between increased social media activity (greater than 2 …


Age-Of-Consent Policies And Hiv Among Adolescents In Sub-Sahara Africa, Suzanne Marie King Jan 2021

Age-Of-Consent Policies And Hiv Among Adolescents In Sub-Sahara Africa, Suzanne Marie King

Walden Dissertations and Doctoral Studies

Age of consent policies have recently been identified as a barrier to HIV testing among adolescents in HIV endemic Sub-Sahara Africa. Grounded in the modified social ecological model, the purpose of this study was to determine if these policies were related to HIV testing rates and prevalence. In this quantitative research secondary data sets from the Demographic Health Survey were used. This study included all sexually active respondents aged 18 years or below (N=37,015) and then was further limited by respondents that had HIV test results (N=25,107). Binary logistic regression showed that respondents with lower age of consent had higher …


Experiences Of Married, First-Time Pregnant Adolescents When Seeking Care In Kano State, Yashua Alkali Hamza Jan 2021

Experiences Of Married, First-Time Pregnant Adolescents When Seeking Care In Kano State, Yashua Alkali Hamza

Walden Dissertations and Doctoral Studies

Kano State in Northern Nigeria has very high maternal mortality rates. Early marriage and early pregnancies between 15 to 18 years of age are two of the most significant factors in the high maternal mortality rates in Kano State. This phenomenological qualitative research study focused on young first-time mothers’ experiences of seeking care between the ages of 15 and 18. The study’s theoretical framework was the feminist theory of intersectionality. Colaizzi’s seven-step method was the means used for data analysis. This study found that young adolescent first-time pregnant women in Kano City faced significant barriers at home and in health …


Factors Associated With Electronic Cigarette Use Among Adolescents In Texas, Christie Anuli Okonkwo Jan 2021

Factors Associated With Electronic Cigarette Use Among Adolescents In Texas, Christie Anuli Okonkwo

Walden Dissertations and Doctoral Studies

The use of electronic cigarettes among adolescents has remained a major public health concern. Reports have shown that the adolescent brain is still growing and can be affected by nicotine and cancer-causing chemicals contained in e-cigarettes. The rising trend of e-cigarette use by adolescents has reportedly reached an epidemic, and there is a knowledge gap in the factors associated with this behavior and the provision of appropriate interventions for the at-risk population. The purpose of this quantitative, cross-sectional study was to investigate the association between sociodemographic factors and the tendency of Texas adolescents to use e-cigarettes. This study was a …


Primary Care Providers’ Perceptions Of Adolescent Friendly Health Services In Relationship To Adolescent Pregnancy, Jill Marie Ensminger Jan 2021

Primary Care Providers’ Perceptions Of Adolescent Friendly Health Services In Relationship To Adolescent Pregnancy, Jill Marie Ensminger

Walden Dissertations and Doctoral Studies

According to recent research, adolescent health continues to be a public health concern. The purpose of this qualitative research was to identify the perceptions of primary care providers regarding adolescent friendly health services and the relationship to adolescent pregnancy. The theoretical and conceptual framework used for this research included the social ecological model and the recommendations of the World Health Organization (WHO) for providing adolescent friendly health services. Using a phenomenological qualitative research approach, interviews were conducted over the telephone. Data analysis included hand coding with emerging themes and subthemes in relationship to each research question. The results of the …


The Primary Care Provider’S Role In Screening And Intervening In The Human Trafficking Of Adolescents: A Systematic Literature Review, Brittany Schmid Jan 2021

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, …