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Public Health and Community Nursing Commons™
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Articles 121 - 150 of 237
Full-Text Articles in Public Health and Community Nursing
Improving Patient Discharge In The Ambulatory Surgical Setting Utilizing A Preoperative Educational Video, Leeann Kluth
Improving Patient Discharge In The Ambulatory Surgical Setting Utilizing A Preoperative Educational Video, Leeann Kluth
The Eleanor Mann School of Nursing DNP Capstone Projects
Background: Use of ambulatory surgery centers providing outpatient surgical procedures has grown due to medical advances, short stays that reduce costs, and convenience for the patient. However, due to the reduced time between diagnosis and surgery, there is a decreased amount of time available for education and discharge teaching. Historically, discharge education is provided after surgery in written form while the effects of anesthesia and pain medication impair a patient’s ability to retain information. This leads to increased reports of uncontrolled pain, poor comprehension, and higher rates of adverse events due to poor comprehension of discharge orders.
Methods: The development …
Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar
Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar
Nursing | Senior Theses
Background
Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.
Objective
To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …
The Effectiveness Of A Webinar To Improve Icu Nurses’ Competency In Palliative Care, Justine Kirschner
The Effectiveness Of A Webinar To Improve Icu Nurses’ Competency In Palliative Care, Justine Kirschner
The Eleanor Mann School of Nursing DNP Capstone Projects
Patients with serious illness lack access to quality patient-centered care despite the growth in palliative care awareness and services. Palliative care is an interdisciplinary care system intended to optimize the quality of life of patients with serious, life-limiting illness and their families. Patients admitted to the intensive care unit (ICU) are facing critical illnesses and can benefit from palliative care integration into their care. This DNP quality improvement (QI) project, grounded in Benner’s Novice to Expert nursing theory, aimed to increase ICU nurse competency in palliative care from novice to competent through a continuing education webinar. The study analyzed nurses’ …
Nurse Practitioner-Led Heart Failure Education Program, Ruairi Fox
Nurse Practitioner-Led Heart Failure Education Program, Ruairi Fox
The Eleanor Mann School of Nursing DNP Capstone Projects
Heart failure is a chronic, progressive disease that has a global burden on the healthcare system and on patient’s lives. HF patients who experience a hospital admission are at a greater risk of being readmitted to the hospital within 30 days, impacting healthcare spending costs and patient quality of life. Self-care activities by patients, such as monitoring weight and making lifestyle changes, are the hallmark of outpatient care, and is shown throughout the literature to reduce readmissions and impact patient quality of life. Unfortunately, many patients are either unaware of proper self-care management techniques or find them hard to follow. …
A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis
A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis
Undergraduate Honors Theses
This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …
Reducing Medication Non-Adherence With Improved Health Literacy Interventions: An Evidence-Based Practice Quality Improvement Project, Unity Wiles
DNP Projects
Introduction
Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate healthcare decisions and follow instructions for treatment. Patients with low health literacy have been predicted to have poor health outcomes. The inclusion of the single-item literacy tool into the admission process of this project involved the patient-centered-care characteristics of improved patient experience, lower health cost, improved clinical experience, and better outcomes.
Purpose
The National Action Plan to improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked multi-sector effort to improve health literacy. Low …
A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah
Capstone Experience: Master of Public Health
This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …
The Relationship Between Perceived Support And Post Traumatic Growth Among Nurses During The Covid-19 Pandemic, Anna Nieman
The Relationship Between Perceived Support And Post Traumatic Growth Among Nurses During The Covid-19 Pandemic, Anna Nieman
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Background: Nurses continue to experience significant challenges related to the COVID-19 pandemic, putting them at risk of occupational stress, burnout, and turnover. The post-traumatic growth model focuses on growth and knowledge that comes from experiences of stress and trauma.
Aim: Identify post-traumatic growth (PTG) in a population of nurses affected by the COVID 19 pandemic.
Method: PTG was measured by the Post-Traumatic Growth Inventory, a 21-item questionnaire with five factors: relating to others, new possibilities, appreciation of life, personal strength, and spiritual change. Participants (n=22) responded on a 6-point Likert scale, 0 for no change and 5 for great degree …
To Flash Or Not To Flash, Christy Overly
To Flash Or Not To Flash, Christy Overly
The Eleanor Mann School of Nursing DNP Capstone Projects
In 2015, healthcare-associated infection (HAI) prevalence survey found that there were an estimated 110,800 surgical site infections (SSIs) associated with inpatient surgeries in 2015. Consequently, instruments and implants sterilized by immediate use steam sterilization (IUSS) have been found to increase the patient’s risk for an SSIs. Due to these risks, the Joint Commission (TJC) determined that organizations should implement evidenced-based protocols to reduce IUSS use. A needs assessment revealed a gap in care in that the increasing SSI rates appeared to be correlated with the misuse of IUSS at the physician owned surgical hospital in Tulsa, Oklahoma. This Doctor of …
Food Insecurity And Charitable Food Services: What Do College Students Think About Such Public Health Interventions?, Kaitlyn Driscoll
Food Insecurity And Charitable Food Services: What Do College Students Think About Such Public Health Interventions?, Kaitlyn Driscoll
Senior Honors Projects
Hunger and food insecurity exist across millions of households in the United States. In 2020, an estimated 1 in 8 Americans were food insecure. The U.S. Department of Agriculture defines food insecurity as a lack of consistent access to enough food required for an individual to maintain an active, healthy life. Food insecurity is associated with an increased prevalence of chronic health conditions and directly affects a student’s ability to learn. Approximately 30% of college students obtaining an education in the United States are currently food insecure. Universities across the country are addressing student hunger via the establishment of on-campus …
Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston
Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …
Safety For Community Health Nurses In Rural And Remote Communities: A Literature Review And Research, Kathlyne Pham
Safety For Community Health Nurses In Rural And Remote Communities: A Literature Review And Research, Kathlyne Pham
Nursing | Senior Theses
Many safety measures devised and implemented are focused on urban hospital settings, which differs from rural and remote settings. Community health nurses are expected to travel and visit their clients’ homes alone, which leaves the nurses vulnerable to their environment. This brings up the question: Does the safety of community health nurses in rural and remote areas have an impact on the care provided in the communities that they serve? After reviewing the six primary literature, three common themes were revealed: lack of boundaries in their personal and professional lives, safety concerns (i.e. isolated geographical locations, workplace violence), and increased …
Exploring The Efficacy Of Herbal & Medicinal Plants Native To China And Thailand As A Complementary & Alternative Treatment In Mitigating Mild-To-Moderate Covid-19 Symptoms, Jiramanee Apiwansri
Exploring The Efficacy Of Herbal & Medicinal Plants Native To China And Thailand As A Complementary & Alternative Treatment In Mitigating Mild-To-Moderate Covid-19 Symptoms, Jiramanee Apiwansri
Nursing | Senior Theses
Background
In December 2019, the World Health Organization (WHO) was informed of an outbreak of an unknown cause of pneumonia-like symptoms in residents concentrated in Wuhan, China; this marked the start of China’s epidemic, which transformed into a pandemic affecting all continents of the world. The cause of the pneumonia-like symptoms was found to be due to the growth and development of the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which spreads through an infected person’s respiratory droplets through activities such as talking, coughing, and sneezing. With COVID-19 vaccine manufacturers available worldwide, even the economically and technologically forward countries …
First Generation Filipino Children And The Risk Of Childhood Obesity: Influence Of Screen Time, Krystal Joy Joy Ragasa
First Generation Filipino Children And The Risk Of Childhood Obesity: Influence Of Screen Time, Krystal Joy Joy Ragasa
Nursing | Senior Theses
Background: Obesity is an epidemic in the United States and among all Asian subgroups, Filipinos are particularly at a much higher risk. Obesity raises the risk of acquiring other health complications, especially for those who develop obesity at a younger age. Research has shown that children who engage in higher levels of screen time are more likely to become obese, resulting in screen time restrictions and recommendations. Additionally, rates of obesity are higher in immigrants. There is a gap in the explanation of screen time’s effect on childhood obesity for first generation Filipino children.
Aim: The purpose of the proposed …
Weight Management Program Using Myfitnesspal© In A Rural Primary Care Setting, Taylor Rittman
Weight Management Program Using Myfitnesspal© In A Rural Primary Care Setting, Taylor Rittman
The Eleanor Mann School of Nursing DNP Capstone Projects
Obesity is a growing health concern that is linked to the development of chronically debilitating physical and mental illnesses. Obesity is a result of a long-term positive imbalance between energy intake and energy expenditure. Evidence has shown more than one third of U.S. adults suffer from obesity. Primary care providers in the United States report being overburdened in treating obesity, citing a lack of time, structured approach, and structured resources. Furthermore, the disparities in obesity are even more prevalent in rural areas where older adults are the fastest growing part of the population at risk for this disease. Evidence indicates …
Effectiveness Of A Frailty Assessment Index To Predict Early Readmission Rates In Frail And Older Adult Renal Transplant Patients, Marilyn Barnett
Effectiveness Of A Frailty Assessment Index To Predict Early Readmission Rates In Frail And Older Adult Renal Transplant Patients, Marilyn Barnett
The Eleanor Mann School of Nursing DNP Capstone Projects
Background: Renal transplantation is a complex intervention integrating both medical and surgical modalities, and is considered the treatment of choice for many individuals with end-stage renal disease. The complicated care of patients undergoing renal transplantation puts them at risk for adverse outcomes including infection, allograft loss, and a greater risk for some types of cancer. Evaluating patients to ensure they have the ability and support to cope with the stress of surgery and recovery, is an important part of determining the most appropriate candidates to receive the limited supply of organs available. Frailty has increasingly been identified as a predictor …
Colorectal Cancer Screening In The Latino Population At A Family Medicine Clinic: A Quality Improvement Project, Michael S. Vinson
Colorectal Cancer Screening In The Latino Population At A Family Medicine Clinic: A Quality Improvement Project, Michael S. Vinson
The Eleanor Mann School of Nursing DNP Capstone Projects
Background: Colorectal cancer (CRC) is a preventable and curable disease that affects all genders, races, and ethnicities, and its impact on society can be reduced with early screening. The Latino population is at greater risk compared to groups or ethnicities due to social determinants and health disparities within the community. Review of Literature: Language barriers, low education levels, persistent social stressors, poor healthcare navigation, and structural barriers make it difficult for this population to be properly screened at appropriate intervals. Purpose: This quality improvement (QI) project was designed to combat reduced screening rates seen in the Latino population. The target …
Effects Of The Covid-19 Pandemic On The Health Behaviors And Feelings Of Career Preparedness Of Baccalaureate Nursing Students, Mary Haggard
Effects Of The Covid-19 Pandemic On The Health Behaviors And Feelings Of Career Preparedness Of Baccalaureate Nursing Students, Mary Haggard
The Eleanor Mann School of Nursing Undergraduate Honors Theses
The aim of this study was to determine if the COVID-19 pandemic affected the health behaviors and feelings of career preparedness of undergraduate nursing students. Participants were recruited from the pre-licensure program at the Eleanor Mann School of Nursing, at the University of Arkansas, Fayetteville during the Fall 2021 semester. The final sample consisted of 92 participants. This study used a cross-sectional design, retrospectively measuring behaviors and attitudes pre-pandemic and during the lockdown period. Two-tailed paired t-tests were run on the health behavior sections and feelings of career preparedness sections independently. Results were deemed significant with an alpha value set …
Nursing Students Attitudes Towards Patients' With Disabilities, Sonny Miles
Nursing Students Attitudes Towards Patients' With Disabilities, Sonny Miles
Honors Theses
Attitudes have been found to impact the quality of healthcare provided to patients. Nursing students are individuals that will eventually care for and impact the livelihood of all individuals including those with disabilities. Measurements of attitudes among nursing students serves to evaluate the efficacy of nursing curriculums regarding disability and determines if revision is needed to better promote healthcare administration for the patient with a disability. This study utilized the Scale of Attitudes Toward Disabled Persons (SADP) to measure attitudes among nursing students enrolled in a baccalaureate nursing program at a Southeastern University. The mean score from participants was 108.49 …
The Nutritional Management And Glycemic Control In Adolescents With Diabetes, Jennifer Durham
The Nutritional Management And Glycemic Control In Adolescents With Diabetes, Jennifer Durham
The Eleanor Mann School of Nursing Undergraduate Honors Theses
The purpose of this literature review is to explore the relationship of nutritional management on glycemic control amongst adolescents who have diabetes. The adolescent population has significant negative or positive peer influence on the management of their diabetes (Yang, 2018, p.104). These peer perceptions can include empathy, curiosity, knowledge seeking, enthusiasm, fearfulness, and bullying (Yang, 2018, p.104). These influences directly affect nutritional management, blood glucose levels, and insulin management. When the peer influence is negative the individual is less inclined to acknowledge their medical condition (Yang, 2018, p.105). Other influences on the management of diabetes include technology, physical exercise, and …
Perceived Sources Of Stress Related To Burnout Amongst Emergency Department Staff Due To The Covid-19 Pandemic: A Literature Review, Sydney Craig
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Emergency departments (ED) are usually considered high stress environments. The effects of the COVID-19 pandemic and the accompanying challenges such as frequent exposure to the novel virus, lack of personal protective equipment (PPE), being over worked and underpaid, and the uncertainty surrounding the overall trajectory of the COVID-19 pandemic have resulted in an increased level of burnout for ED staff, especially nurses. This study involves a meta-analysis of current literature surrounding ED burnout including incidence rate and causes during the COVID-19 pandemic. Because studies indicate upwards of three fourths of ED staff reporting increased stress and burnout, finding ways to …
The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell
The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell
Undergraduate Honors Theses
Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …
Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge
Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge
Electronic Theses and Dissertations
Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …
Knowledge Of The Effect Of Synthetic Proteins On The Overall Health In Lebanese Adults: A Cross-Sectional Study, Zeina Al Shoufi, Alaa Al Bardan, Ahmad Shishnieh, Rami Asaad, Hiba Deek
Knowledge Of The Effect Of Synthetic Proteins On The Overall Health In Lebanese Adults: A Cross-Sectional Study, Zeina Al Shoufi, Alaa Al Bardan, Ahmad Shishnieh, Rami Asaad, Hiba Deek
BAU Journal - Health and Wellbeing
The aim of the study was to assess the knowledge of gym attendees on the effects of protein shakes on their health. A descriptive cross-sectional study involving a self-administered questionnaire was undertaken. Data were collected through a self-administered questionnaire in two ways. First method was googled form links which was sent out to acquaintances on social media (WhatsApp, Facebook, Instagram and Twitter) in both English and Arabic language. In addition, questionnaire was printed and distributed to four different gyms in Beirut. The coaches of the gyms took charge of distributing and completing the questionnaire. Reminders were issued every 2 days …
Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho
Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho
The University of Louisville Journal of Respiratory Infections
Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.
Dnp Final Report: Sane Finder: A Web-Based Mobile Solution To Identify The Location Of Currently Available Sexual Assault Nurse Examiners (Sane) For First Responders, Brenda D. Herrmann
Dnp Final Report: Sane Finder: A Web-Based Mobile Solution To Identify The Location Of Currently Available Sexual Assault Nurse Examiners (Sane) For First Responders, Brenda D. Herrmann
DNP Final Reports
Society views sexual assault as one of the most horrific crimes committed by one human being against another, but the “rescue” has the potential to make the experience even more difficult for the victim, in essence re-traumatizing them (Nugent-Borakove et al., 2006). In the United States in 2018, almost 140,000 victims reported being sexually assaulted (U.S. Department of Justice - Federal Bureau of Investigation, 2019). In Texas, over 6 million individuals have been sexually assaulted in their lifetime (Busch-Armendariz et al., 2015). Getting victims to a specially trained sexual assault nurse examiner (SANE) as quickly as possible improves outcomes. SANEs …
Dnp Final Report: Psychosocial Screening For Oncology Patients, Robyn V. Beard
Dnp Final Report: Psychosocial Screening For Oncology Patients, Robyn V. Beard
DNP Final Reports
Background: Patients with cancer often face severe distress related to fear of death, body disfigurement, financial stress, and lack of support system. This distress may lead to physical and emotional symptoms that bring patients to seek care at emergency departments, delay care or make poor health choices, and increase utilization of prescription drugs. With the already over burdened healthcare system, addressing these psychosocial needs is vital to improving patients outcomes as well as improving healthcare expenditure. Purpose: The purpose of this evidence based practice project was to improve perceived quality of life for oncology patients through detailed screening and behavioural …
Using A Food Insecurity Screening Tool In The Nicu, Emily Coffman Bsn, Rn, Fatina Caldwell Bs, Bsn, Rn, Cpn, Cpen, Mackenzie Box Bsn, Rn, Uche Anani Md, Faap, Christin Fritz Md, Mph, Bobby Bellflower Dnsc, Nnp-Bc, Faanp
Using A Food Insecurity Screening Tool In The Nicu, Emily Coffman Bsn, Rn, Fatina Caldwell Bs, Bsn, Rn, Cpn, Cpen, Mackenzie Box Bsn, Rn, Uche Anani Md, Faap, Christin Fritz Md, Mph, Bobby Bellflower Dnsc, Nnp-Bc, Faanp
Doctor of Nursing Practice Projects
Purpose/Background: Infants admitted to the NICU are disproportionately born to low-income families. This, combined with unique financial challenges of their long-term stay, may predispose caregivers to food insecurity (FI). FI among caregivers has far reaching implications for the health of infants who are already vulnerable related to comorbidities from their NICU stay.
Methods: Using the Iowa model to successfully engage key stake holders and begin a small pilot study, a randomized preintervention chart audit was performed (n=30) to evaluate if FI was identified by NICU Social Worker (SW). The FI screening tool was administered by nursing to a separate group …
Development Of An Experienced Quality Measure For Clients, Informal And Formal Caregivers In Home Care In The Netherlands: A Participatory Action Research, Roy Haex, Theresa Thoma-Lürken Phd, Anna J.H.M. Beurskens Phd, Sandra M.G. Zwakhalen Phd, Rn
Development Of An Experienced Quality Measure For Clients, Informal And Formal Caregivers In Home Care In The Netherlands: A Participatory Action Research, Roy Haex, Theresa Thoma-Lürken Phd, Anna J.H.M. Beurskens Phd, Sandra M.G. Zwakhalen Phd, Rn
Patient Experience Journal
To optimise home care provision and to identify potential improvements in the care process, it is important to gain insight into the care experiences that influence care quality. The aim was to develop a qualitative experienced quality measure for home care in The Netherlands, facilitating conversations between clients and caregivers in generating possible points of improvement for the primary care process. A participatory action research design to develop the measure following three iterative cycles, using various data sources in evaluating requirements related to the goal, feasibility in care setting, and usability in the care process. The final design comprises an …
Dnp Final Report: Adolescent Support For Healthy Living, Kristin S. Hudson
Dnp Final Report: Adolescent Support For Healthy Living, Kristin S. Hudson
DNP Final Reports
Adolescents often make decisions that negatively impact their health and wellness. They do this for many reasons including impulsivity, underdeveloped communication and coping skills, feelings of invincibility, and a perceived lack of support. In adolescents, how does education and training related to risky behaviors compared to no education affect knowledge, skills, and understanding (KSU) of high-risk behaviors three months after instruction? Thirteen peer- reviewed articles were utilized in the body of evidence. A curriculum-based intervention was implemented. Outcomes include an overall increase in KSU in six key concepts including contraception, substances abuse, sexually transmitted diseases/infections, teen pregnancy, peer pressure, and …