Public Health and Community Nursing Commons^™

Improving Health Literacy And Self-Management In Adults With Heart Failure: A Nurse-Led Virtual Intervention In Outpatient Support Groups, Vivian Efosa Osunde

Doctoral Projects

Heart failure is a leading cause of morbidity and hospital readmissions, with limited health literacy contributing to poor self‑management and adherence challenges. The purpose of this Doctor of Nursing Practice project was to evaluate the feasibility and preliminary outcomes of a nurse‑led, virtual education-intervention designed to improve health literacy, self‑care behaviors, and medication adherence among adults with chronic heart failure who participate in an outpatient support group. A quality improvement design was used. Convenience sampling yielded nine adult participants with a documented diagnosis of chronic heart failure who attended at least one virtual support group session. The intervention consisted of …

Increasing Health Literacy To Improve Cardiovascular Risk Factors In Patients With Low Socioeconomic Status In The Appalachian Region: A Quality Improvement Project, Kara M. Dougherty

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Improving health literacy is one of the main goals of Healthy People 2030. However, there are no evidence-based guidelines as health literacy is still in research status (Office of Disease Prevention and Health Promotion, n.d.). Vulnerable populations are especially at risk of having low health literacy skills. Social determinants of health, such as poverty, lack of access to care, few community resources, and low health literacy, are common issues throughout Appalachia, which includes West Virginia. These disparities negatively impact the success of primary and secondary prevention for cardiovascular disease (Mangini et al., 2018). This quality improvement project utilized the …

Kid Power: Mastering Asthma Management To Keep Hospitals Away!, Kriste L. Moret

Master's Projects and Capstones

Problem: Pediatric asthma remains a leading cause of preventable hospitalizations, particularly in California’s Central Valley, where environmental and health disparities worsen symptoms. Many children are discharged without understanding their Asthma Action Plan (AAP) or feeling confident in symptom management.

Context: On a unit in a community hospital in this high-risk region, asthma-related admissions persisted. Gaps in discharge education highlighted the need for a structured intervention. The Institute for Healthcare Improvement (IHI) Model for Improvement (MFI) guided this effort.

Intervention: A nurse-led, developmentally appropriate asthma education bundle was implemented. Teaching began on admission and was reinforced using teach-back, color-coded AAPs, culturally …

Healthy Bytes: Enhancing Health Literacy In Older Adults Through Technology Services, Gianna M. Susa

Master's Projects and Capstones

This quality improvement project aimed to enhance health literacy among senior residents through interactive technology workshops. Aim During a twelve-week period from January 22, 2025, to March 31, 2025, this project aimed to increase technology proficiency among senior residents from 0% to 75%. Methods A 5P Microsystem assessment and preliminary survey revealed residents' interest in technology workshops. Based on this feedback technology workshops were implemented once a week for a twelve-week period. Each session provided one on one support to help residents navigate online health portals, communicate with providers, and interpret health information. A SWOT analysis and Fishbone analysis were …

Health Literacy, Health Perception, And Influencing Factors Among Immigrants, Canan Birimoglu Okuyan, Ebru Deveci, Fatma Karasu

Makara Journal of Health Research

Background: Individuals living in rural areas face several healthcare disadvantages, including limited access to medical facilities and specialists during emergencies. This study examines healthy lifestyle behaviors, health perceptions, and influencing factors among immigrants in a rural region of southern Türkiye.

Methods: This cross-sectional study involved immigrants registered at a family health center. Data were collected using a sociodemographic questionnaire, the Perception of Health Scale, and the Health Literacy Scale.

Results: Statistically significant differences in THLS-32 scores were found based on participants’ occupation, marital status, and education level (p < 0.05). A moderately positive correlation was observed between health literacy and health perception scores (p < 0.05).

Conclusions: Research on the relationship between …

Partnering With A Family Shelter To Increase Access To Mychart, Elizabeth S. Stehle, Brenna Becerra, Zahra Diallo, Kristin Grassell, Cassandra Rodriguez-Cruz, Elaine Ahn, Lola Duropan

Nursing Leadership in Community Engagement Projects

Partnering with a Family Shelter to Increase Access to MyChart

Over the past two months, our group of seven nursing students has collaborated with a local nonprofit homeless shelter for women and families. Many of the guests served by this organization are refugees or asylum seekers who have little to no exposure to the American healthcare system. Whether this is due to a low level of health literacy or lack of education surrounding access to health care, we identified a need in this population to increase the number of guests who can easily access their healthcare information. This need led …

Improving Health Literacy Related To Hypertension In A Minority Faith-Based Population, Kasaundra M. Beverly-Marshall, Kasaundra M. Beverly-Marshall

Doctor of Nursing Practice Scholarly Projects

Background: Insufficient research on health literacy related to cardiovascular disease highlights a gap in healthcare. Healthy People 2030 and local community health programs acknowledge gaps in research with future goals to improve health literacy.

Local Problem: The health literacy rate for Winnebago County, IL (41%) is higher than both the State of Illinois and national health literacy rates, which aligns with the results of a community needs assessment survey.

Methods: A community-based health promotion project using a pre-post study design uses the health promotion model to engage participants in advancing cardiovascular health outcomes.

Interventions: DNP student assisted participants in creating …

Increasing Health Literacy Within The Unhoused Population, Alyse Mk Abraham, Zoe J. Foucaultt, Sean P. Sieber, Simran Gill, Andrew Kang, Fatou Goudiaby

Nursing Leadership in Community Engagement Projects

Nursing Leadership Executive Summary

The unhoused population in Washington State increased by 12% from January 2022 to January 2023, underscoring a growing regional crisis (Washington State Department of Commerce, 2024). To serve this population, we partnered with an agency in Western Washington. In collaboration with the agency’s health services administrative director, we developed a multilingual handout on healthcare and insurance options to improve health literacy.

Our project involved a windshield survey, demographic analysis, evidence-based research, and collaboration with translators to ensure accessibility. This paper outlines the project’s development, research process, creation of the handout, and its intended impact.

Background

A …

Improving Health Literacy Through Knowledge And Technology, Maricela Hernandez

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Health literacy is key in promoting positive health outcomes, particularly in older adults who often face difficulties understanding and managing complex medical conditions. Limited health literacy contributes to poor management of chronic conditions and health disparities, especially in disadvantaged populations.

Objectives: This project aimed to improve health literacy in older adults through a health literacy bundle.

Design: A pre/post single group design was used to evaluate the impact of the health literacy bundle on participants’ health literacy levels. The intervention was conducted over eight weeks.

Setting: The project was implemented in a small rural town in South Texas with …

Empowering Low-Income Women With Breast Cancer: Promoting Acupuncture At Community Health Fairs, Katrina Ramos

Nursing | Senior Theses

While research has explored the positive effects of acupuncture on cancer and cancer treatment symptoms, a notable gap exists in understanding its impact on lower-income populations. These individuals encounter barriers to accessing acupuncture, such as limited availability, cost, and provider knowledge. This longitudinal study aims to assess the impact of community health fairs, featuring acupuncture information for breast cancer and chemotherapy-induced symptoms, on the acceptance and utilization rates of acupuncture among low-income women with breast cancer. Collaborating with the Women’s Cancer Resource Center and a local non-profit integrative cancer care clinic in Oakland, we will conduct a three-day health fair …

At The Heart Of Nursing: A Literature Review On Health Literacy Education In Nursing Curricula And Preparation For Patient Teaching Encounters, Samantha Garcia

Honors Undergraduate Theses

Background: Health literacy is defined as one’s ability to find, comprehend, and utilize information to make health decisions (Office of Disease Prevention and Health Promotion, n.d.). Globally, nursing students are exposed to the concept of health literacy during their degree-seeking years, yet no formal health literacy education exists across nursing curricula in pre-licensure programs at the associate and bachelor levels. This lack of standardization and non-emphasis of health literacy as a formal topic within education has contributed to poor provider performance and, in turn, low health literacy rates that may lead to suboptimal patient outcomes.

Significance: Studies have found that …

Hypertension Education To Enhance Health Literacy, Kylee Westrip

Student Scholarly Projects

Practice Problem: The health of patients suffers greatly when their health literacy is not addressed through evidence-based education material.

PICOT: The PICOT question that guided this project was, in adult patients with hypertension (P), how does evidence-based education material (I) compared to the current state of verbal instructions provided (C) affect health literacy rates based on the high blood pressure health literacy scale (O) within 12-weeks (T)?

Evidence: The literature evidence revealed three strong themes, which included information on who is most at risk for low health literacy levels, education delivery methods, and specific education to be used.

Intervention: …

A Retrospective Review Of A Local Healthcare Process Designed To Improve Understandability, Actionability, And Readability Of Written Documents For Veterans, Erica Wilson

College of Health Sciences Posters

Preventable chronic diseases are plaguing our veterans. Health literacy is an important component of prevention and chronic disease self-management. People need health literacy skills to read and understand information. The Veterans Health Administration (VHA) calls the Veterans Health Education and Information (VHEI) Committee for a review process to improve the understandability, actionability, and readability of VHEI resources.

This retrospective review of a local evidence-based process improvement is being implemented at the Washington DC Veterans Affairs Medical Center (DCVAMC) to satisfy a VHA directive to improve the understandability, actionability, and readability of written materials. The local process improvement involves a robust …

Empowering Low-Income Women With Breast Cancer: Promoting Acupuncture At Community Health Fairs, Katrina Ramos

Nursing | Student Research Posters

No abstract provided.

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 …

Health Literacy In Acute Care Benchmark Study, Micah Duke

MSN Capstone Projects

Poor health literacy levels directly correlate to poor patient discharge adherence and to an increase in repeat emergency department visits and healthcare costs. In addition, poor health literacy levels are directly correlated to a decrease in patient health outcomes. Studies clearly demonstrate that determining patient health literacy levels can be used to develop appropriate discharge instructions and education that will improve patient adherence and health outcomes, thus reducing emergency department readmissions and healthcare costs.

The purpose of this benchmark project is to implement procedures for consistently obtaining patient health literacy levels, along with language preferences, using the HLS-SF12 and to …

Discerning The True Dilemma Of Diabetes Among Hispanics, Ramon Ponce

Nursing | Senior Theses

There is a common misconception that the primary role of nurses is to follow doctors’ orders and treat patients who are currently suffering and experiencing pain. Chronic illnesses such as diabetes can be prevented and better managed if the population who is greatest at risk is better informed and educated on the disease. Different cultures and ethnicities have different foods that unfortunately puts them at risk to get diabetes. Hispanics typically follow a diet that is high in carbohydrates, saturated fats, and sugars that greatly contribute to the development of diabetes. Often, Hispanics are not educated enough to comprehend the …

Pediatric Health Literacy, Morgan E. Sapper, Grace G. Lloyd

Senior Honors Projects, 2020-current

Abstract

Background: Unless you are a healthcare provider or licensed healthcare professional, understanding the United States healthcare system and its accompanying medical jargon can be confusing and overwhelming to try to navigate. Even more difficult is comprehending what resources are available to specific populations and how to gain the most benefit from these offered resources. Limited health literacy skills have been identified as the largest barrier in identifying an individual’s health outcomes. Health affects every stage of life. The purpose of this paper is to analyze what health literacy implementations look like as well as the age and developmental stage …

Prescription Labels: Get To Know Them, Karen Adams

Doctor of Nursing Practice Projects

Low health literacy is a problem for millions of Americans resulting in increased use of healthcare resources resulting in poor health outcomes. The older adult population is continuing to grow and is the largest user of healthcare. Use of pharmaceutical regimens to manage chronic illnesses is the most commonly used treatment modality. Unfortunately, people with low health literacy may have trouble understanding and following their providers instructions. It can be difficult to read directions on over the counter and prescription medication bottles. Community-based health educational programs benefit the maintenance of older adult health. The purpose of this project was to …

Assessing The Health Literacy Levels Of Diabetic Patients Located In Rural Southeast Kansas, Meghan Murray

Doctor of Nursing Practice Scholarly Project

Data shows that limited health literacy is prevalent throughout the United States. This data has also found a correlative relationship between limited health literacy and poor health outcomes. An individual’s health literacy level affects many areas of their health, including their ability to effectively manage chronic diseases, such as diabetes mellitus. Awareness of an individual’s health literacy level allows for targeted interventions and a potential improvement for a patient’s health outcomes. The Newest Vital Sign (NVS) is a validated screening tool that allows for the identification of a patient’s likely health literacy level. The purpose of this Doctor of Nursing …

Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean

Evidence-Based Practice Project Reports

Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …

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 …

“I Was Relieved To Know That My Baby Was Safe”: Women’S Attitudes And Perceptions On Using A New Electronic Fetal Heart Rate Monitor During Labor In Tanzania, Sara Rivenes Lafontan, Johanne Sundby, Hege L. Ersdal, Muzdalifat Abeid, Hussein L. Kidanto, Columba Mbekenga

School of Nursing & Midwifery, East Africa

To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This knowledge is important to identify barriers towards adaptation in order to introduce new technology more effectively. We carried out 20 semi-structured individual interviews post-labor at two hospitals in …

Health Literacy Assessment And Chronic Disease: An Integrative Review, Dana S. Woody

Doctoral Dissertations and Scholarly Projects

Health literacy is a matter of grave concern in health care today. Defined as more than the ability to read and write, it involves obtaining, processing, and understanding health information. Yet it is a concept often misunderstood and overlooked in the environment of professional care. Specifically, low health literacy in the setting of chronic disease has proven to be a challenging and costly phenomena. Given the high prevalence of chronic disease, there is a pressing need for health care providers to acknowledge this subject matter in care delivery. This integrative review provides a synthesis of published evidence identifying and clarifying …

The Effect Of An Educational Intervention On Knowledge And Intent To Participate In Cervical Cancer Screening, Ann Marie Trapp

Evidence-Based Practice Project Reports

Globally, cervical cancer ranks third among cancers affecting women (Arbyn et al., 2013). In the United States, approximately 12,000 women are diagnosed with cervical cancer and approximately 4,000 women die yearly (Centers for Disease Control and Prevention, 2014). Papanicolaou (Pap) screening is an effective means of detecting precancerous cell changes of the cervix with early cervical cancer diagnosis carrying a 91% five-year survival rate (Gonzalez et al., 2012). The purpose of this evidence-based practice project was to identify interventions that increase adherence to cervical cancer screening and to implement best practices to reduce unnecessary deaths related to late diagnoses of …

Barriers To Diabetes Care In Appalachia: Challenges Faced By Healthcare Providers, Megan Cullinan

Senior Honors Theses

Appalachia is a region of the United States that is characterized by high rates of poverty, low levels of education, elevated incidence of chronic disease, and inadequate healthcare. Compared to the national average, the area has an elevated incidence of Type 2 diabetes. Though this disease process is an issue that must be addressed by healthcare providers, these providers face many challenges and barriers to providing adequate care for this disease in the Appalachian population. Barriers to care include geography with limited transportation, an inadequate number of healthcare personnel, patient inability to afford healthcare, patient attitudes toward diabetes care, and …