Public Health and Community Nursing Commons^™

Evaluating The Nutritional Status Of Peruvian Born Children, Chantelle Garcia Medina

Honors Undergraduate Theses

Background: Rural areas of Peru lack access to healthcare resources and poor nutritional knowledge of what should be given to their children throughout their growth and development. The majority of the rural areas rely on a high carbohydrate, moderate vegetable diet, and lacking a protein source. Lower protein intake can lead to problems of malnutrition and growth stunting. Families rarely have monetary resources to provide a protein at every meal for the entire family. There is also a lack of a clean water supply, free of parasites and helminths. Caregivers often rely on replenishing intake with other fluids high …

Creating A Community-Based Protocol To Prevent Unintended Pregnancy In Homeless Women In Monongalia County, West Virginia, Jessica Eva Wukasch

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: At any given time, 10% of homeless women are pregnant, about twice the rate of all U.S. women of reproductive age (5%) (Healthcare for the Homeless, 2001). According to Healthcare for the Homeless Council ([HHC], 2012), approximately “73% of pregnancies among homeless women were unintended at the time of conception.” In addition, “about 12% of homeless children are placed in foster care compared to 1% of other children” (HHC, 2012). There is an evident need to address unintended pregnancy among homeless women.

Objective: The overall objective was to create an accessible and useful community-based protocol to reduce the rate …

Street Medicine And Its Implications, Dylon Hess

Student Research Poster Presentations 2020

No abstract provided.

Extraction And Analysis Of Data For Fragility Fracture Patients To Help Determine The Likelihood Of Follow-Up With A West Michigan Fragility Fracture Service, Michael Joseph Lamphere

Doctoral Dissertations

Fragility fractures and secondary fractures are a large physical, financial, and emotional drain on the individuals and families affected. Improving post fragility fracture care and increasing follow-up rates with specialty services, such as a fracture liaison service, may promote post-fracture recovery and help prevent future fractures. The purpose of this doctoral project was to increase and improve post osteoporotic fracture care by increasing appropriate referrals and follow-up care. Patient data was retrieved and analyzed on 60 fragility fracture patients referred to a local fracture liaison service. The analysis found that patient gender, fracture site, and history of a previous fracture …

Residential Radon Exposure, Its Contribution To Lung Cancer, And Social Determinants Of Radon Testing, Stacy Stanifer

Theses and Dissertations--Nursing

Lung cancer is a highly preventable form of cancer. Cigarette smoking is the leading cause of lung cancer followed by radon gas exposure and exposure to secondhand smoke. Kentucky leads the nation in both incidence and mortality from lung cancer. Tobacco use in Kentucky continues to be a major public health concern as nearly one-quarter of adults report current tobacco use and just over one-third of Kentucky homes with children lack rules which prohibit smoking in the home. Radon, a colorless, odorless radioactive gas, occurs naturally from the decay of uranium found in rocks and soil and is harmful when …

Associations Between Psychosocial Stressors, Genes, And Cardiovascular Disease In At-Risk Adults, Kaitlin Voigts Key

Theses and Dissertations--Nursing

Psychosocial stressors have a significant adverse impact on cardiovascular health. While better medical treatments and increased emphasis on healthy lifestyle have improved cardiovascular health for many in the United States over the past 50 years, there are persistent inequities in cardiovascular disease (CVD) rates, with the highest rates among populations burdened by chronic exposure to psychosocial stressors such as discrimination and anxiety, among others. Genetic factors may interact with these stressors further influencing the rates of CVD in these populations. The purpose of this dissertation is to examine associations among psychosocial stressors and other CVD risk factors, and the influence …

Tobacco Use And Nicotine Withdrawal Among Patients With Mental Illness, Yazan Daher Al-Mrayat

Theses and Dissertations--Nursing

People with mental illness (MI) are disproportionately affected by tobacco use compared to the general population. In fact, it is estimated that people with MI consume approximately 44% of cigarettes smoked in the United States. Moreover, the MI population is at greater risk for the negative social, economic, and health consequences associated with tobacco use and are reported to have 25-year shorter life expectancies than the general population. The impact of tobacco use is further noticeable among patients with MI who require psychiatric hospitalization. Quitting smoking in this population has been linked to fewer discharges against medical advice, better quality …

Metformin’S Role In The Prevention Of Type 2 Diabetes In Individuals Diagnosed With Prediabetes: A Systematic Literature Review, Jillian Williamson

All Graduate Theses, Dissertations, and Other Capstone Projects

The United States is facing a growing epidemic of unchecked and untreated individuals with prediabetes. While lifestyle interventions have remained the gold standard of treatment, has this been enough? A literature review was carried out to identify metformin’s role in treatment and management of prediabetes as well as perceived barriers to its prescribing. A total of 24 articles met inclusion criteria. Main findings include (a) metformin is effective in reducing the incidence of diabetes, though not as effective as lifestyle interventions; (b) certain populations did benefit more from metformin usage then other populations; (c) there was more treatment compliance with …

Benefits Of Exercise On Mental Health: Literature Review, Angela Ristau

All Graduate Theses, Dissertations, and Other Capstone Projects

Providers diligently educate patients on exercise to reduce the risk of cardiovascular disease, hypertension, diabetes, and stroke. However, in recent years, providers judiciously educate patients on exercise and its correlation to improving or impacting mental health disorders. Physical activity has been steadily shown to relate to improved physical health, life satisfaction, cognitive functioning, and psychological well-being. A large body of literature examines the impact of physical activity and exercise on mental health. There is a growing interest in the use of exercise in the treatment of depression and anxiety, as a primary option or as an adjunct to pharmacological treatment. …

Application Of The Unified Theory Of Acceptance And Use Of Technology Model To Predict Dental Students' Behavioral Intention To Use Teledentistry, Jafar H. Alabdullah, Bonnie L. Van Lunen, Denise M. Claiborne, Susan J. Daniel, Cherng-Jyh Yen, Tina S. Gustin

Dental Hygiene Faculty Publications

Abstract

Teledentistry is an innovative technology that can be used to improve access to care and oral health outcomes. Dental students’ intention to use teledentistry after completing dental school has not been investigated.

Purpose

The unified theory of acceptance and use of technology (UTAUT) was used to predict intentions to use teledentistry among 4th-year U.S. dental students. Methods A cross-sectional approach was performed for a 7-week period in Spring 2019. All U.S. dental schools (N = 66) were invited to participate and 16 schools agreed to participate. An anonymous survey link was emailed to academic deans for dissemination to students. …

Using Social Media As A Platform For Increasing Knowledge Of Lung Cancer Screening In High-Risk Patients, Aimee Strong, Michelle Renaud

Ellmer School of Nursing Faculty Publications

Background: Uptake in lung cancer screening for high-risk patients remains low. Eligible patients may not know that this preventive service is available and covered by insurance.

Objectives: The objective of this study was to explore using social media to educate patients about lung cancer screening and assess motivation to discuss lung cancer screening with health-care providers after viewing the educational program. Methods: Subjects ages 55 to 77 who were current smokers or former smokers who quit in the past 15 years with a more than 30-pack-year smoking history were recruited via a Facebook advertisement. Subjects completed a demographic survey and …

The Relationship Between Intensity Of Fitness Tracker Usage And Motivation, Rachel Cannata, Abigail C. Daugherty, Madison O. Dirocco, Julianne Green, Pial Dasgupta

Williams Honors College, Honors Research Projects

Many college students engage in unhealthy behaviors which may contribute to diseases. Additionally, some students may lack motivation to rectify these behaviors to improve their long-term health. This study assessed the relationship between intensity of fitness tracker usage and motivation among health professions students at a large, public Midwestern university. This non-experimental, correlational study used convenience sampling and a theoretical framework based on Bandura’s Social Cognitive Theory. Online recruitment announcements were emailed and included links to the consent form and survey. Motivation was measured with Deci and Ryan’s modified self-determination tool. Intensity of tracker usage was measured using a scale …

Knowledge Levels, Attitude And Beliefs Of Men Towards The Digital Rectal Examinations (Dre): A Study In Trinidad, Philip C. Onuoha, Gloria Mootoo-Ramdeen, Melany Romany, G La Fleur-Roseman, J Roopnarine, D Diaspia-Murrell, K Martin-Boucaud, P Hypolite

Internet Journal of Allied Health Sciences and Practice

Background: Trinidad and Tobago have been ranked as having one of the highest cancer mortality rates in the Caribbean. Prostate cancer was identified as the most common cancer in men, with a higher mortality than any other cancer. At least 1 in 9 men in Trinidad and Tobago will be diagnosed with prostate cancer during his lifetime. Purpose: The purpose of this study is to determine knowledge levels, attitudes, and beliefs of men aged 40 years and over regarding digital rectal examination (DRE). The investigators considered this crucial following the scourge of prostate cancer in Trinidad and Tobago and an …

Listening To The Voices Of Community Health Workers: A Multilevel, Culture-Centered Approach To Overcoming Structural Barriers In U.S. Latinx Communities, Angela L. Palmer-Wackerly, Virginia Chaidez, Caitlyn Wayment, Jonathan Baker, Anthony Adams, Lorey A. Wheeler

Department of Nutrition and Health Sciences: Faculty Publications

Community Health Workers (CHWs) are often incorporated into efforts to reduce health disparities for vulnerable populations. However, their voices are rarely the focus of research when considering how to increase their job effectiveness and sustainability. The current study addresses this gap by privileging the voices of 28 CHWs who work with Latinx communities in Nebraska through in-depth, semi-structured interviews. Using a multilevel, Culture-Centered Approach (CCA) to Health Communication, we identified two key structural communication issues: (a) increasing language accommodation and (b) increasing (and stabilizing) network integration across three ecological levels of health behavior (individual, microsystem, and exosystem …

Reducing Hypertension Through Faith Community Nursing, Michelle White

DNP Research Projects

Hypertension affects approximately 31.1% of adults (1.39 million) worldwide. It continues to be a significant risk factor for cardiovascular disease and strokes, the leading causes of death in the United States (Mills, Stefanescu, & He, 2020). Hypertension is expected to increase due to the aging population and unhealthy lifestyle choices of the American people (American Heart Association [AHA], 2018a). Therefore, effective strategies are required to manage hypertension in order to decrease stroke and cardiovascular events that can save the lives of many Americans. National programs such as Healthy People 2020 are working to achieve blood pressure control within the United …

Examining Body Mass Index And Sepsis Mortality At One Year After Sepsis, Jamie D. Robinson

Theses and Dissertations

Introduction: Sepsis is a serious and life-threatening syndrome affecting 1.7 million Americans annually and resulting in approximately 270,000 deaths. An “obesity paradox” where obese individuals have lower sepsis mortality than their non-obese counterparts has been described. The problem is that the longevity of the effect is unknown, and few studies have examined the obesity paradox after 1-2 months post-diagnosis.

Methods: This retrospective cohort study examined clinical, demographic, and biomarker variables thought to affect sepsis mortality at three-time points: 30 days, 180 days, and at one year post-sepsis diagnosis in order to shed light on specific factors that might define …

An Interprofessional Clinical Placement In A Primary Healthcare Setting: A Pilot Study, Christina Aggar, Beth Mozolic-Staunton, Renee Joyce Lovi, Maggie Scorey, Melissa Kemp, Tara Walker, Sian Lewis

Internet Journal of Allied Health Sciences and Practice

Purpose: Internationally, and in Australia, interprofessional education (IPE) is becoming typical in primary healthcare delivery and is core to delivering patient-centred care. It is essential that primary healthcare education develop interprofessional capacity in order to produce a skilled workforce. An IPE clinical placement for undergraduate health students was developed and piloted in primary healthcare settings. The aim of this study was to evaluate the impact of the IPE clinical placement in a primary healthcare setting on students’ perceptions of interprofessional education. Method: A pre-post placement validated questionnaire (n=19) indicated overall perceptions of IPE significantly increased over the course of …

Factors Related To Health-Related Quality Of Life In Patients With Acute Coronary Syndrome In West Java, Indonesia, Haerul Imam

Chulalongkorn University Theses and Dissertations (Chula ETD)

This descriptive study aimed to examine the relationship between age, self-efficacy, functional status, pain, dyspnea, social support, and health-related quality of life in patients with acute coronary syndrome in west java, Indonesia. The participants were 186 patients who has acute coronary syndrome or history of acute coronary syndrome visited cardiovascular outpatient clinic in the main national public hospital type A in west java province, Indonesia. The instruments used for data collection were Demographic Questionnaire, General Self-efficacy Scale, Seattle Angina Questionnaire, Rose Questionnaire for Angina, Rose Dyspnea Questionnaire, ENRICH Social Support, and MacNew Health Related Quality of life. These instruments were …

Best Youth Education Methods For Sexually Transmitted Infection Prevention, Caitlin F. Walchonski

All Graduate Theses, Dissertations, and Other Capstone Projects

Sexual health education in the United States is inconsistent; information and methods vary from one location to another. Education plays a large role in developing safe sex practices, and despite the sexual education efforts, rates of sexually transmitted infections have risen for five consecutive years in the United States. A systematic literature review was conducted to determine the best methods for educating adolescents to promote behaviors to enhance sexual health. Multiple types of interventions have been studied including cognitive behavioral interventions, comprehensive sexual education, parent and teen dyad education, and abstinence only education. Sexual behavior is influenced by a variety …

Patient Satisfaction With Telehealth Services Compared To In-Office Visits: A Systematic Literature Review, Crystal L. Fleischhacker

All Graduate Theses, Dissertations, and Other Capstone Projects

Telehealth is changing the current paradigm of healthcare. As an emerging mode of healthcare delivery, telehealth stands to help alleviate the shortage of primary care and specialty care providers especially patients in rural areas. In addition to increasing access of healthcare, this service allows for flexibility, convenience and has the potential to decrease healthcare costs while improving patient outcomes. The objective of this literature review was to examine patient satisfaction with telehealth compared to in-office visits. A systematic search was conducted and a total of 17 articles that met inclusion criteria were examined. Data and factors evolving around patient satisfaction …

Homeless Tailored Primary Care And Access To Ongoing Primary Care Services, Jessica J. Stoefen

All Graduate Theses, Dissertations, and Other Capstone Projects

Homelessness is an increasing problem worldwide. The system for providing medical care to individuals experiencing homelessness is currently a patchwork of multiple different agencies. Many individuals do not utilize routine primary care (PC) services, instead present to emergency departments for nonemergent care. A systematic literature review was conducted using Cochrane Database of Systematic Reviews, CINAHL Plus with Full Text, Consumer Health Complete – EBSCOhost, and PsycINFO from 2014-2019 with the exception of Cochrane which was searched from 2009-2019, to evaluate if tailored PC clinics focused on providing PC services with additional supports to homeless individuals were more effective at engaging …

Cost-Effectiveness Of A Mobile Health-Supported Lifestyle Intervention For Pregnant Women With An Elevated Body Mass Index, Elizabeth O'Sullivan, Salwa Rokicki, Maria Kennelly, Kate Ainscough, Fionnuala M. Mcauliffe

Articles

Objective To assess the cost-effectiveness of a mobile health-supported lifestyle intervention compared with usual care.

Methods We conducted a cost-effectiveness analysis from the perspective of the publicly-funded health care system. We estimated costs associated with the intervention and health care utilisation from first antenatal care appointment through delivery. We used bootstrap methods to quantify the uncertainty around cost‐effectiveness estimates. Health outcomes assessed in this analysis were gestational weight gain (GWG; kg), incidence of excessive GWG, quality-adjusted life years (QALYs), and incidence of large-for-gestational-age (LGA). Incremental cost-effectiveness ratios (ICERs) were calculated as cost per QALY gained, cost per kg of GWG …

Evaluation Of The Impact Of An Educational Intervention Aimed At Improving Tuberculosis Infection Control Knowledge Among Health Care Workers In A Military Treatment Facility: A Quality Improvement Project, Allen C. Potter

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Florida (FL) is one of the top five states in the nation for Tuberculosis (TB) infections. A majority of new infections can be found in the minority populations which represents 78% of all TB infections in the state. A combination of TB rates in FL, Orlando located 60 miles away and a transient population who frequently deploys worldwide to austere locations may result in an increased risk of acquiring TB. Literature suggests Health Care Providers (HCPs) obtain training regarding TB Infection Control (TB-IC). The Patrick AFB Military Treatment Facility (MTF) lacked a TB Infection Control (TB-IC) plan. Objective: The …

Quality Improvement Of Substance Misuse Screening Of Older Adults In Primary Care Using Evidence-Based Training, Kelly Lopez

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background

The largest increase in preventable overdose deaths from 1999-2017 occurred among adults 50 and older, yet substance misuse among older adults is often not screened for or recognized in primary care settings. This oversight has been attributed to many factors, including age-related biases, unrecognized psychosocial and physiological differences, stigmatization, and a rapidly growing geriatric population.

Objectives

A quality improvement program using evidence-based educational training was implemented in a primary care setting with the intention to expand care knowledge and ultimately improve screening practices of older adults, especially those suffering from substance misuse.

Design

This quality improvement (QI) project used …

Integrating Care: Evaluation Of A Hepatitis C Clinic Co-Located With Harm Reduction And Addiction Treatment Programs In A Rural Clinic, Susan Ruth Mckenrick

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: West Virginia (WV) is second in the nation for cases of Hepatitis C Virus (HCV) per capita – meaning more than 24,000 residents are living with HCV. Most new cases are in young persons who inject drugs (PWID). However, the no-call, no-show rate for HCV patients coming to clinics in Morgantown is about 50%, indicating the need to do a better job engaging them in care. Literature suggests that integrating HCV clinics with harm reduction and addiction treatment programs increases uptake of HCV treatment.

Objective: The overall objective was to establish an integrated HCV clinic where harm reduction …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

Preparing Healthcare Staff For Cardiac Arrest Codes In The Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes, Rowan Edwards, Rn

Master's Projects and Capstones

Preparing Healthcare Staff for Cardiac Arrest Codes in the Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes

The acuity of care provided in outpatient clinical settings across the United States continues to rise. It is estimated that more than 350,000 cardiac arrests occur outside of a hospital each year (AHA, 2019). For the purpose of this clinical nurse leader (CNL)-lead quality improvement project, the relevant focus is directed towards improving the knowledge, physical skills and perceptions of healthcare staff within an urgent care center (UCC) regarding the application of advanced rescue skills. It is important to note that the …

Transitions Of Care: Raising Awareness And Improving Identification Of The Social Determinants Of Health, Stephanie Le

Master's Projects and Capstones

Problem: Hospital readmission rates have steadily climbed in the United States and the cost of unplanned readmissions can be detrimental. It has been identified that greater discharge preparation and quality care coordination greatly impacts the patient’s plan of care and reduces the risk of unplanned 30-day readmissions. Transition programs help reduce the psychosocial barriers that prevent patients from being able to self-manage their conditions outside the acute setting and help patients effectively navigate the through the continuum of care.

Context: Research has shown that when the social determinants of health (SDOH) barriers are identified appropriately and early-on, this can decrease …

Improving The Rate Of Hand Hygiene Immediately Before And After Wound Care In The Street Nurse Microsystem, Amanda Ramos Sandoval

Master's Projects and Capstones

The street nurse team of Sacramento, CA provides many services to patients who are experiencing homelessness, including a substantial amount of wound care. While the street nurses were performing hand hygiene (HH) prior to and after wound care, they would often not be performing it immediately prior and post-wound care. Because the nurses hike to their patients (who are living on the streets or in out of the way camps) the street nurses would often perform hand hygiene while at their cars prior to going to the patient and again when they returned to their cars after performing wound care. …

Assessment Of Structural Competency In Baccalaureate Nursing Students: A Descriptive Study, Elle J. Del Gallo

Senior Honors Projects, 2010-2019

Cultural competence has been investigated extensively in nursing education to better prepare nurses to care for individuals of diverse backgrounds. While developing cultural competence is important to address individual care needs, it may not address the social and structural factors that influence health. Structural competency describes the ability to assess not only cultural factors that affect health disparities, but also structural inequalities and stigmas that can alter a patient’s presenting symptoms and risk for certain diseases.