Medicine and Health Sciences Commons^™

Adaptations Made To Evidence-Based Public Health Programs In Low- To Middle- Income Countries: A Concept Mapping Analysis, Elizabeth Holguin

Nursing ETDs

One of the most challenging barriers to implementing successful and sustainable evidence-based programs in public health is the ability to remain faithful to original protocols grounded in scientific evidence while adapting programmatic components to reflect the reality of the communities they are meant to benefit. It is generally accepted that some degree of adaptation should occur in order to achieve positive, sustainable outcomes in public health programs. A concept mapping methodology was used to explore types of adaptation that occur during implementation of evidence-based global health programs in low- to middle-income countries (LMICs). Purposive and snowball sampling produced a sample …

Determining The Adoption And Implementation Of Nutrition Policies At Food Pantries Across The United States, Meagan Helmick

Theses & Dissertations

Food insecurity occurs when there is a lack of access to enough food to live an active, healthy life. Current efforts to address food insecurity include developing and implementing policies, programs, and practices at the federal, state, and local levels. Specifically, local efforts target decreasing food insecurity through emergency food networks including food banks and food pantries. Over the last several years, many food banks and food pantries have worked to improve the nutritional quality of the foods they offer. However, food pantries are smaller and less formal organizations than food banks. Thus, they have limited resources to develop and …

From Evidence To Practice: A Systematic Approach To Implementing Electrical Stimulation Therapy For Treating Pressure Injuries In Community Dwelling Individuals With Spinal Cord Injury, Deena Lala

Electronic Thesis and Dissertation Repository

Pressure injuries are a common secondary health complication among individuals with a spinal cord injury (SCI) and can have a profound effect on quality of life. Unfortunately, pressure injury care in community dwelling individuals with SCI is often fragmented and inconsistent across Canada. Current best practice guidelines strongly recommend the use of electrical stimulation therapy (EST) to manage pressure injury in this population; however, there is little uptake of EST, and is not considered as a first-line treatment by many clinicians. Therefore, the objective of this dissertation is two-folds 1) to determine the impact of pressure injuries on individuals with …

Factors Related To Successful Implementation Of An Aac Device For An Individual With Autism, Michaela Worms

Dissertations, Theses, and Projects

Communication impairment is a defining characteristic of autism spectrum disorder (ASD) (American Psychiatric Association, 2013); therefore, the use of augmentative and alternative communication (AAC) has become an essential part of language intervention for children with autism that experience significant difficulties with communication (Flores et al., 2012). Assessing children’s preferences for AAC options may be important with respect to AAC abandonment, which is a problem in the AAC field (Johnson, Inglebret, Jones, & Ray, 2006). This single-subject study identified factors related to successful implementation, acquisition, and usage of an AAC system. The clinician collected baseline data on the client’s spontaneous production …

Early Integration Of Palliative Care For Patients Diagnosed With Life-Limiting Illness, Jennifer M. Rivers

Theses and Graduate Projects

There are numerous reasons conversations regarding the early implementation of palliative care for patients diagnosed with life-limiting illness do not occur early in the disease trajectory. A literature search was conducted to support the benefits of earlier implementation of palliative care, specifically, implementation by patient’s primary care providers upon a qualifying disease diagnosis. The literature review revealed generous benefits of early implementation of palliative care and provided support for this scholarly project. For this scholarly project, a palliative care questionnaire and PowerPoint presentation were designed, administered, and presented to health care providers including nurse practitioners, physician assistants, pharmacists, and consultants …

Implementation Of Provider And Workflow Strategies To Increase Adherence To Tqip Guidelines In Traumatic Brain Injury, Regina Thompson

Theses and Dissertations

Traumatic brain injury (TBI) is a leading cause of death and permanent disability worldwide. The American College of Surgeon’s Trauma Quality Improvement Program (TQIP) has developed a set of recommendations for the management of trauma-related injuries, including TBI. The objective of this evidenced-based practice project was to implement provider- and workflow-based strategies to improve adherence to TQIP recommended guidelines for the placement of intracranial pressure (ICP) monitors. The primary outcome measured was number of ICP monitors placed post-intervention.

The author reviewed available literature and found six articles pertaining to guideline implementations. Analysis of the literature was performed utilizing Melynk and …

Implementation Of A Depression Screening Tool For Cardiovascular Patients In The Primary Care Setting, Amber Nicole Ballentine

Theses and Dissertations

Background: Patients with cardiovascular disease (CVD) have a two-fold increased risk of depression as compared to patients without CVD. According to the American Heart Association (AHA, 2016), there is no gold-standard procedure for screening for depression in cardiovascular patients. Screening for depression varies greatly across specialties and practices, often leaving a gap for detection and treatment of depression in cardiac patients. There are many depression screening tools available; however, the AHA recommends use of the patient health questionnaire (PHQ) screening tool. The PHQ-2 and PHQ-9 questionnaires are the most brief, sensitive, and specific depression screening tool for patients with …

Implementation Of An Evidenced-Based Opioid Treatment Program To Improve Maternal-Child Outcomes In Eastern Kentucky, Jordan Rice

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Kentucky River Area District Health Department proposes implementation of CHARM-Kentucky, a treatment program for pregnant women with opioid use disorder (OUD), in eastern Kentucky. Over 115 Americans die each day from an opioid overdose, resulting in approximately 42,000 deaths in 2016. In addition to an overall increase in opioid use in recent years, the use of opioids in pregnancy has also increased from 1.19 per 1,000 hospital births in 2000 to 5.63 in 2009. Opioid use during pregnancy results in poor neonatal outcomes including: low birth weight, preterm delivery, small head circumference, increased child maltreatment, and risk for long-term …

Assessing Barriers And Facilitators To Appropriate Care For Chronic Pain And Prescription Opioid Abuse, Allyson Varley

All ETDs from UAB

The objective of this study was to understand and assess barriers and facilitators to the uptake of appropriate care for co-occurring chronic noncancer pain (CNCP) and opioid use disorder. Rates of CNCP and opioid overdose have doubled in the past decade. When a patient transitions from appropriate use to misuse, significant changes must be made to their treatment plan. Considering most CNCP is treated with opioids in the primary care setting, primary care providers (PCPs) are potential change agents to remediate the epidemic of opioid abuse. Although studies have explored opioid stewardship, we still lack an understanding of the factors …