Public Health and Community Nursing Commons^™

Exploring What It Is Like To Be An Undocumented Alien In Seek Of Healthcare, Eliany C. Torrez Pon

Honors Undergraduate Theses

Currently, there are about 11.8 million undocumented aliens in the United States who are not eligible for public insurance or any type of private coverage obtained through the American Health Care Act of 2017. This creates barriers to healthcare for this large population and has negative implications for the healthcare system. Despite the availability of clinics and low-cost healthcare, this group tends to underuse resources or seek healthcare for emergencies only which leads to increased cost totaling approximately $1.1 billion a year. The goal of this qualitative study is to better understand what it is like to be an undocumented …

Making A Global Impact One Vaccine At A Time, Janice E. Hawkins, Deborah C. Gray

Ellmer School of Nursing Faculty Publications

(First paragraph) Did you know that, worldwide, almost one third of deaths among children under age 5 can be prevented by vaccines? It's stunning to think that one child dies every 20 seconds from an immunization-preventable disease. That equates to 12 lives that could be saved in the time it takes to read this brief article!

The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell

DNP Projects

BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.

PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.

METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …

Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan

Asian/Pacific Island Nursing Journal

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach.

Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Strategies To Improve Control Of Blood A1c In Diabetics, Jennifer Aronson, Leanne Bellino, Elizabeth Eisenhardt, Diane Bryant, Haley Pelletier, Internal Medicine Team, Adult Outpatient Clinic

MaineHealth Maine Medical Center

A1c monitoring is an important aspect of controlling the health of a diabetic patient. An adult internal medicine clinic noted that the percentage of their diabetic patients who had an A1c higher than 9 or no reading within the past year exceeded the national average. As a result, operational excellence methods were implemented with the overall goal to reduce their percentage to 18% or less.

A root cause analysis identified several deficiencies to includelack of essential equipment, variations in

staff education and the absence of daily reminders.

Post KPI implementations, an overall decrease in the percentage of patients with poorly …

Food Insecurity And Its Impact On Health Status Among Homeless Individuals: An Integrative Literature Review, Jacqueline Munyasya

Grace Peterson Nursing Research Colloquium

FOOD INSECURITY AND ITS IMPACT ON HEALTH STATUS AMONG HOMELESS INDIVIDUALS:

AN INTEGRATIVE REVIEW

Jacqueline Munyasya

Faculty Sponsor: Dr. Shannon Simonovich

Background: Food insecurity is a serious problem in the United States and the number of people affected by food insecurity in the United States has risen dramatically in recent years. The homeless population is disproportionately affected. The combination of homelessness and food insecurity is a problem has the combined effect that is extremely costly to the public and the overall health of the population. As nurses, we will encounter these populations and treat them in both community and acute …

Effective Methods For Domestic Violence Screening In The Emergency Department, Megan Bryan

Grace Peterson Nursing Research Colloquium

Abstract

Background: The CDC reports that one in four women and one in ten men will experience some form of domestic violence in their lifetime that will have either a short-term or long-term impact on their well-being. Often the first place these victims are seen where they can receive help is the emergency department. Objectives: The goal of this systematic integrative literature review was to explore existing literature on domestic violence screening methods used in the emergency department and determine which methods prove most effective. Concurrently, this review examined the barriers to effective domestic violence screening and how nursing education …

Evaluating The Role Of Community Advisory Boards: With Persons Who Inject Drugs In Photovoice Research, Nicole Pallas

Grace Peterson Nursing Research Colloquium

Background: The use of community advisory boards (CABs) is a source of leadership in community-based participatory research (CBPR); however, not all researchers have incorporated CABs, and others have restricted CAB involvement for feasibility purposes. Although there is literature about utilizing CABs in a variety of CBPR studies, less is known about the challenges and successes of working with persons who inject drugs (PWIDs) as CAB members in photovoice methodology, as well as their perceptions throughout the process.

Objectives: The purpose of this qualitative study was to investigate the role CABs play in photovoice research while determining PWIDs’ capacity to fulfill …

A Delphi Study: Guidelines For Researchers Working With Teenage Mothers, Alison M. Chamberlain

Nursing Theses and Dissertations

Problem: It is difficult to get teenage mothers to participate in studies, yet some researchers have been successful. Researchers who understand the barriers to conducting studies with a vulnerable population and are guided in ways to overcome these barriers, will experience greater success when doing studies with this group. Improved study methods can lead to larger numbers of teenage mothers who participate in studies. Researchers who follow developmentally appropriate guidelines are more likely to conduct and replicate studies with this population. Access is essential to advance the science related to care for teenage mothers who are at risk for many …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

The Public Health Harms Of Pornography: The Brain, Erectile Dysfunction, And Sexual Violence, John D. Foubert

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …

Text Messaging Appointment Reminders To Increase Patient Appointment Adherence Within A Prevention And Wellness Program, Janel Willingham

Graduate Theses, Dissertations, and Capstones

Abstract

Healthcare organizations want to provide quality care, decrease costs, and promote preventative services for the communities they service. Mobile health units have become an extension of many healthcare organizations and provide different types of services, such as mammography. Providing mammography and wellness exams on a mobile unit presents several challenges; appointment adherence is one of them. Mobile units typically travel to underserved areas to serve people at risk for various health conditions such as breast cancer. Breast cancer is estimated to affect over 250,000 women in the United States during 2017; women have a 1:8 lifetime risk of being …

Improving Patient Outcomes: Early Mobilization Of Intensive Care Patients, Casey Teves

Honors College Theses

Early mobilization of intensive care patients has gained the interest of researchers within the last few years due to its safe and practical application and numerous benefits it can provide. Reviewing the literature on this topic reveals the substantial benefits of early mobilization and the detrimental effects of prolonged bed-rest. Despite recent evidence proving that this practice will increase quality of care, many intensive care units still utilize bed-rest as a standard. Understanding the barriers and facilitators of this change can help transform this research into practice and improve patient care outcomes. Nurses are the key facilitators in the initiative …

Poster: Communication Strategies For The School Nurse Mentor: A Pilot Training Program, Amy Hotler Dnp, Rn, Lsn, Aphn-Bc

Doctor of Nursing Practice Scholarly Projects

Mentorship has widespread support among many disciplines for the impact on improved job satisfaction, decreased job turnover and decreased costs to organizations. Ongoing support through mentorship is critical to nurses transitioning to a new role and nurse mentors must be prepared for the role with relevant education tailored to their needs . Though literature describing training programs for mentors is limited, some studies have reported an increase in confidence among mentors after training. In addition, improved mentoring skills (that includes communication) is in literature.

In one large urban school district in Ohio, a school nurse, mentorship program was developed and …

Chuukese Migrant Women In Guam: Perceptions Of Barriers To Health Care, Margaret Hattori-Uchima

Asian/Pacific Island Nursing Journal

This descriptive qualitative study examined perceived barriers to health care among Chuukese migrant women in Guam and explored which factors influenced health-seeking behaviors. Study participants recommended interventions which may reduce those perceived barriers. Since the Compact of Free Association with the United States was enacted in 1985, there has been a dramatic rise in the numbers of Chuukese migrating to Guam. This migration is anticipated to continue with more migrants needing health care, education, and social services. Little is known about their perceptions of barriers to health care services or the cultural, social, economic, and other factors that influence their …

East Meets West: Cultural Values And Duty To Care For Disaster Response, Tracy J. Nash

Nursing Theses and Dissertations

Nurses’ readiness for disaster response has assumed front and center-stage in recent years, due to the heightened number of natural and human-induced disasters across the globe. Scientific literature affirms that without nurses’ personal and professional readiness for disaster situations, patient and public health outcomes will likely decline. Three research manuscripts presented in this dissertation portfolio targeted this significant, but overlooked public health issue. First, a quantitative pilot study addressing nurses’ personal preparedness for disaster response was considered. Findings from the study not only justified personal readiness as a significant concept, but also prompted review of the scientific literature to further …

Influencing College Influenza Vaccination Through A Multi-Component Campaign, Heather Strickler

Evidence-Based Practice Project Reports

Multiple influenza strains exist and college aged students are the most affected population from the H1N1 strain. The H1N1 influenza pandemic had high attack rates reported on campuses from 25% to 73% (Benjamin et. al., 2016; Uddin et. al., 2009). Only 8% to 40% of college students are vaccinated against influenza despite a target goal of 50% set by the American Healthy Campus 2020 (Benjamin et. al., 2016; Poehling, et. al., 2012). The purpose of this evidence based project was after implementing a multi-component influenza vaccination campaign to determine changes in intent to receive the vaccine among college students. To …

The Benefits Of Breastfeeding, Annagrace E. Anderson

Senior Honors Theses

Breast milk is the gold standard for infant nutrition. In the past, infant formula was promoted as equal or superior to breast milk. However, research has shown that breastfeeding is the superior form of infant nutrition except in rare circumstances. Breast milk provides for all of a newborn’s caloric needs and has the correct balance of nutrients to promote proper development. In addition, breast milk provides protection against illnesses, supports an infant’s immune system, and promotes life-long health for the newborn. Mothers also experience personal benefits by breastfeeding such as decreased cancer risks, bonding with their babies, and faster postpartum …

Screening, Brief Intervention And Referral To Treatment Implementation In The Emergency Department, Arvind Venkat Md, Gary Shank Phd, Sherry Rickard-Aasen, Janice Pringle Phd, William Johnjulio Md

The Qualitative Report

We sought to qualitatively evaluate impediments in implementing a novel Screening, Brief Intervention and Referral to Treatment (SBIRT) protocol into normal emergency department (ED) workflow for patients with at-risk drug/alcohol behavior. From 2010, administrative and nursing champions trained nurses at a single ED (census: 50,000 visits/yr) in SBIRT and incorporated SBIRT into normal ED nursing workflow in 2012. To qualitatively analyze impediments in SBIRT implementation, we created a semi-structured questionnaire for protocol champions with subsequent follow-up. Investigators analyzed responses using qualitative methodology based on a modified grounded theory framework. In 2012, 47693 visits by 31525 patients met SBIRT protocol initiation …

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

Childhood Obesity: Physiological And Psychological Implications And Ethical Responsibilities, Connie S. Lewis

Journal of Health Ethics

Childhood obesity continues to be a health concern in the United States with physiological and psychological consequences. Research conducted in schools may address the physiological effects and exacerbate negative psychological effects, including weight bias and stigmatization. In the home, children are dependent on parents/caregivers to provide a healthy diet and exhibit a healthy lifestyle.The ethical theory, ethics of care, emphasizes dependence and interdependence on others, and ethical and moral responsibilities in the parent/child relationship. The assurance of ethical considerations involving children in research and parental provision for healthy dietary provision is of utmost importance. Any action or inaction that results …

Seven Foundational Principles Of Population Health Policy, Dhrubajyoti Bhattacharya, Jay Bhatt

Nursing and Health Professions Faculty Research and Publications

In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address …

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 …

Goals Of Exclusive Breastfeeding And The Effectiveness Of Programs And Initiatives In Attaining Them, Natalie Scott

Senior Honors Theses

Over recent years, breastfeeding has gained renewed significance in research and practice. Both in the United States and around the world, especially in poor countries that do not have easy access to quality healthcare, breastfeeding has been shown to dramatically and positively affect the health and lifespan of infants. However, there is still a low prevalence of effective breastfeeding practices universally. Even with the presence of global programs and goals that are geared toward exclusive breastfeeding habits, global rates are lower than what is desired. There are various determinants of breastfeeding that factor into a woman’s decision and practice of …

A Systematic Review: The Prenatal And Postnatal Events Associated With Infant Mortality Rate (Imr), Ariel L. Thomas, Sarah A. Awwad, Briana E. Clark

Williams Honors College, Honors Research Projects

Infant mortality rate (IMR) is an indication of overall population health, maternal and child health, accessibility and quality of primary health care, and the availability of community resources. The current IMR in the United States is high despite advances made in the medical field. The purpose of our systematic review is to describe and critically appraise research about prenatal events, postnatal events, and increased infant mortality rate and to give nursing practice recommendations to help decrease the rate. We used CINAHL, Medline and PubMed to find 20 research articles. Overall, the research stated that going to prenatal visits had a …

Screening For Alcohol Use/Abuse In The Primary Care Setting Using The Audit-C And Sbirt (Screening, Brief Intervention, Referral To Treatment), Whitney D. Spear

DNP Projects

PURPOSE: The purpose of this study was to examine the feasibility of alcohol screening in the primary care setting to detect alcohol abuse or misuse using the AUDIT-C standardized screening tool and SBIRT.

METHODS: This study design was a Quasi-Experimental intervention, one group post-test. Data was collected via retrospective chart review from the electronic medical records by the type of office visit; either new patient initial visit or annual well visit. The patient sample consisted of 25 participants for the study period of September 19^th through October 10^th, 2017.

RESULTS: There were 37 patients eligible to participate …

Use Of The Afix Model To Improve Adolescent Hpv Vaccination: A Pilot Research Study, Emily Messerli

DNP Projects

Problem: The CDC estimates one person every 20 minutes every day acquires an HPV-related cancer. Kentucky’s HPV associated cancer burden is among the highest in the nation. Adolescent HPV vaccination rates in Kentucky are far below HealthyPeople 2020 goals. Barriers are multifaceted and include provider, patient and system barriers. The AFIX model is an evidenced based quality improvement program that addresses key provider barriers. The USPSTF findings identify a gap in the literature related to AFIX methods to improve rates of adolescent vaccines.

Objectives: The purpose of this study was to evaluate the effects of an intervention using the AFIX …