Community Health and Preventive Medicine Commons^™

Stroke Preventive In African American Women Ages 20-40 That Are Using Or Have Used Oral Contraceptives, Ashanti L. N. Coleman

Electronic Theses and Dissertations

This Doctor of Nursing Practice project will inform the audience of stroke awareness as it pertains to oral contraceptives. The study’s focus was to enhance the knowledge of African American women ages 20–40 that have used or are currently using an oral contraceptive. It has been identified that this patient population lacked the knowledge regarding stroke and oral contraceptives, and African American women continue to have the highest incidence of stroke. African American women also make up more than half of the consumers utilizing oral contraceptives. An oral contraceptive knowledge questionnaire was utilized from previous research to determine if any …

Decreasing Readmissions In Medically Complex Children, Colleen Bartlett

Student Scholarly Projects

Practice Problem: There was a report of an existing practice problem of increased 30-day readmission rates in medically complex children at an outpatient clinic within an extensive hospital system. Hospital readmissions can cause clinical, social, and financial burdens to the patients and their families and thus reflected a need for interventions to reduce readmissions.

PICOT: The PICOT question that guided this change project: In medically complex pediatric patients ages 0-17, what is the effect of a discharge intervention bundle in reducing all-cause 30-day hospital readmissions compared to current practice within an 8-week timeframe?

Evidence: The literature revealed 18 …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Decreasing Inappropriate Usage Of The Emergency Department (Creating Alliances To Deliver Population Health To Seasonal Workforce), Olivia Foster, Lynley Steele-Miller

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No abstract provided.

Empowering The Lowland Indigenous Community Through Child Health And Nutrition Program In Occidental Mindoro Province, Philippines, Artemio Morado Gonzales Jr

ASEAN Journal of Community Engagement

Nutrition and child health programs were integrated into the extension programs from 2016-2018 of the Occidental Mindoro State College, in partnership with the local government unit at the municipal and barangay levels. This paper presents the health extension tools and techniques used in preventative care and the promotion of child health services in the indigenous community of Sitio Bato Singit, in the Occidental Mindoro Province, Philippines. Health education, small group techniques, demonstrations, storytelling, informal talks, and open forums were the methods and techniques employed to implement the program. The common tools used were seating arrangements, flip-charting, props, social hours, and …

Solutions To Address Frequent Hospital Attendance, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

In this editorial, practical solutions and considerations in helping the most complex and at-risk patients in our health systems are discussed. These patients, sometimes referred to as health care “super-utilizers” in the literature, tend to be frequently seen and cared for in costly hospital and emergency department settings. Innovative care models that aim to bridge system gaps, achieve better health outcomes, and improve the well-being of both patients and providers are needed and should continue to be explored.

Defining And Characterizing Frequent Attenders: Systematic Literature Review And Recommendations, Dip Shukla, Erik Faber, Brian Sick

Journal of Patient-Centered Research and Reviews

Purpose: To decrease cost and improve efficiency, health care organizations have focused on frequent attenders — patients with high health care utilization. Prior studies have investigated singular health care settings, used varying definitions of frequent attendance, and inconsistently identified factors correlated with frequent attendance. The purpose of this article is to suggest a uniform definition of frequent attenders for different health care settings and to determine factors correlated with frequent attendance.

Methods: This systematic review of three databases identified 2761 unique articles; 174 met inclusion criteria. Studies were analyzed for their definition of frequent attenders and factors associated with frequent …

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

Recommended Syphilis And Hiv Testing After Positive Sti Testing, Katherine Cayce Monaghan Rn, Bsn

Doctor of Nursing Practice Final Manuscripts

Background: Historically primary and secondary syphilis were seen primarily among men who have sex with men and rates among women remained low and rarely increased. Recent research shows that between 2013–2017, the primary and secondary syphilis rate increased 72.7% in the U.S. and 155.6% among women. Patients diagnosed with syphilis have a two to five fold increased risk of acquiring human immunodeficiency virus (HIV). Additionally, positive testing for other sexual transmitted infections (STI) might be indicators of high risk sexual behaviors and exposures that place a person at greater risk for acquiring syphilis and HIV. A southern California university student …

Screening For Iron-Deficiency Anemia In The Pediatric Population (Ages 1-17) In Gonaïves, Haiti, Cara Rose Fratianni

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this pilot project is to screen for iron-deficiency anemia in pediatric patients (ages 1-17) in a primary school in Gonaïves, Haiti. Patients with anemia will be treated with oral supplemental iron for a period of four weeks according to WHO guidelines (WHO, 2011). All students will be treated empirically for helminths per WHO guidelines, unless treated elsewhere in the last six months (WHO, 2017). Nutritional status will also be assessed using MUAC according to WHO guidelines (2017).

Background Summary: Malnutrition contributes significantly to the problem of iron-deficiency anemia, with one in four children exhibiting stunting …

The Expansion And Evaluation Of Medication Assisted Treatment Services For An Underserved Rural Northern California Community, Carolyn Perrotti

DNP Qualifying Manuscripts

Problem: Widespread opioid misuse has led to the opioid epidemic that claims 130 deaths per day due to an opioid overdose (CDC, 2018). The opioid epidemic has plagued the United States for three decades and has been considered a public health emergency since 2017 (HHS, 2017). Rural communities are disproportionately affected by this problem and in 2014, the rate of opioid overdose deaths was 45% higher in rural communities (SAMHSA, 2018).

Context: Medication-assisted treatment (MAT) is considered the most effective treatment for opioid dependence because it incorporates medication management and biopsychosocial supports (Jones et al., 2018). Retention in a MAT …

Initiating Prep In Primary Care: Addressing The Adolescent And Young Adult High Risk Populations, Igor G. Mocorro

Doctor of Nursing Practice (DNP) Projects

Problem: Adolescents and young adults (AYA) ages 13 to 24 comprise a quarter of the new HIV diagnoses in the United States. Lack of access to HIV-preventive therapies such as pre-exposure prophylaxis (PrEP) reduces opportunities to prevent HIV infection in this population. Initiating PrEP in AYA significantly reduces the negative health outcomes of HIV, but it is evident that many clinicians are still reluctant to initiate PrEP in AYA patients based on perceived threats and barriers.

Context: Primary care clinics, including school-based clinics, have an opportunity to offer HIV prevention services including PrEP. This project, the Adolescent and Young Adult …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

Prevalence Of Hypertension And Its Risk Factors Among Cotton Textile Workers In Low- And Middle-Income Countries: A Protocol For A Systematic Review, Naureen Akber Ali, Anam Shahil Feroz

School of Nursing & Midwifery

Background: Cotton workers are exposed to various hazards in the textile industry that might result in different ailments including hypertension (HTN). However, few attempts have been made to systematically review the prevalence of hypertension and its risk factor among cotton textile workers in low-and middle-income countries (LMICs). The objective of this study will be to evaluate the prevalence of hypertension and its risk factors among adult cotton textile workers in low- and middle-income countries.
Methods: We designed and registered a study protocol for a systematic review of descriptive epidemiology data. We will include observational studies (e.g., cross-sectional, cohort, surveys) on …

A Faith-Based Quality Improvement Project To Increase Awareness, Prevention, And Management Of Coronary Heart Disease In African Immigrants, Temitope S. Okpebho

Doctor of Nursing Practice Projects

Problem Description: Coronary heart disease (CHD) affects people globally, and it is the leading cause of death in the United States. Despite increased CHD awareness, evidence shows the increased prevalence and low CHD awareness among African Immigrants. According to Boateng et al. (2017), African immigrants are more likely to have CHD risk factors and be unaware. This may be due to changes in eating habits, lack of physical activity, increased stress level, and the adaptation of the Western diet.

Rationale: This project included implementing a culture care theory in a faith-based organization to increase awareness, management, and prevention of CHD …

Mass Matters: Increasing Mammography Rates To Underserved Women, Ingrid N. Cooper

Evidence-Based Practice Project Reports

Breast cancer is the most frequently diagnosed cancer among women in Indiana and the United States (Indiana Cancer Organization, 2019). An estimated 268,000 new cases of invasive breast cancer were diagnosed and 41,760 women died due to breast cancer in 2019 (ACS, 2019). Substantial breast cancer-related morbidity and mortality disparities persist among the underserved. Disparities in breast cancer outcomes are due to lower mammography screening rates, lack of timely follow-up of abnormal results, and lack of timely treatment initiation among women with breast cancer (Highfield et al., 2015). The purpose of this evidence-based practice project was to address low mammography …

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

Take A Shot: The Effect Of A Multicomponent Strategy To Increase Meningitis B Vaccination Rates, Valerie Cline

Evidence-Based Practice Project Reports

Neisseria meningitidis is the major cause of invasive meningococcal disease (IMD) (Peterson et al, 2018). Approximately 10-15 percent of IMD cases result in debility including neurological impairment, amputation, and death (Peterson et al, 2018). Outbreaks of IMD are sporadic and unpredictable. The incidence of IMD varies geographically, but serogroup B has become more prevalent in recent years. Meningitis-B (Men-B) has been the cause of several university outbreaks on different US college campuses since 2013.The purpose of this project was to implement an intervention at a midwestern university student health center to help students understand the risk of the disease and …

The Effects Of A Nutritional Intervention On Healthy Eating Habits And Body Mass Index, Kelley Eshenaur

Evidence-Based Practice Project Reports

In the US, overweight and obesity are growing concerns, as both can have life altering consequences if not prevented or treated. Since 2000, there has been nearly a 10% increase of adults who are obese, from 30.5% (85.8 million) to 39.8% (93.9 million) in 2016 (CDC, 2017). These conditions are preventable with early intervention and motivation. Obesity statistics are especially of interest during the transition to young adulthood. The purpose of this project was to improve student outcomes by identifying barriers, effective strategies, and healthy choices that would ultimately impact weight, increasing healthy food choices, and decreasing overall BMI in …

Does Access To Telephone Counseling Improve Smoking Cessation In Disadvantaged Populations?, Karin Warden-Thomas

Evidence-Based Practice Project Reports

Tobacco usage leads to the development of a multitude of diseases. Years of research have shown that evidence-based interventions such as counseling and pharmacotherapy increase smoking quit rates. Studies have demonstrated that either proactive or reactive telephone counseling has been beneficial in providing long term smoking abstinence particularly in disadvantaged populations (Haas et al., 2015). The purpose of the project was to improve smoking cessation by facilitating access to telephone counseling using an electronic medical order. The Stevens Star Model of Knowledge Transformation (Stevens, 2004), was the framework employed to support the process for change. This evidenced-based project occurred at …

Improving Health Insurance Literacy Within Our Community Through The Use Of Local Libraries, Bonnie Gregg, Jenny Lieu

Doctor of Nursing Practice Projects

Low health literacy is associated with a poorer ability to understand medical information leading to disparities among all ages. Communities play a role in supporting efforts to improve health literacy. Libraries are trusted institutes that offer an environment for all members of the community and serve as places of lifelong learning. A needs assessment approach determined a gap in knowledge regarding health literacy and insurance, specifically the Affordable Care Act (ACA). This project was an exploratory, community improvement project. Information was presented in educational sessions at two local libraries. Participants were also given an informative brochure to accompany the presentation. …

Living Sweet: A Multi-Functional Mobile-Phone Application Strategy For Adults With Uncontrolled Type 2 Diabetes Mellitus, Chantel K. Anderson

Evidence-Based Practice Project Reports

Type 2 Diabetes Mellitus (T2DM), one of the most common chronic diseases, is increasing worldwide, and once diagnosed, lifetime self-management is critical to maintain glycemic control (Vermeire et al., 2005; American Diabetes Association (ADA), 2018). Management of T2DM has been acknowledged as challenging due to the need for strict lifestyle adaptations. From a public health perspective, uncontrolled diabetes leads to increased healthcare costs, secondary complications, and ultimately severe disabilities (ADA, 2018). The purpose of this evidencebased practice (EBP) project was to evaluate the effectiveness of a diabetes-specific mobile health application (MHA) on glycated-hemoglobin (HbA1C), self-care perception (SCP), and self-care behaviors …

Continuous Glucose Monitors To Decrease Hypoglycemia, Sara B. Woodcock

MSN Capstone Projects

Diabetes is a disease that affects millions of people from children to older adults. There is no cure, although it can be managed to prevent complications. Education of student nurses is where they are born and raised to become nurses who save and change lives. Teaching student nurses in depth about diabetes as a disease and the treatments that best fit their specific needs is where educating patients begins. Learning about a secondary option for blood glucose checks can make all the difference for several patients. Multiple finger sticks daily has been the leading way to check blood sugar for …

Increasing Patient Adherence To Gestational Weight Gain Goals In Pregnancy, Annie Vining

Dissertations

Abstract

Problem: The inability to maintain healthy weight gain during pregnancy may contribute to multiple pregnancy-related complications. Nutritional education and support may improve nutrition and vitamin consumption, and recommendations for healthy gestational weight gains have been published. However, pregnant women have reported minimal advice regarding healthy weight gain during pregnancy. A personalized, nutritional counseling program was initiated in a Midwestern, suburban OB-GYN private practice.

Methods: A quality improvement descriptive, correlational design was used. A cohort of pregnant women first trimester through six-weeks postpartum received individual counseling and face-to-face interaction at an office visit each trimester.

Results: Twenty ( …

Community Cooking Course To Combat Nutritional Knowledge Deficit, Heather R. Bohman

MSN Capstone Projects

More than two-thirds of American adults and almost one-third of American children are overweight or obese. Not only are the statistics alarming, the cost of obesity is staggering. Obesity robs an individual of their quality of life and costs the U.S. healthcare system an estimated $147 billion a year in obesity-related illness (Finkelstein, Trogdon, Cohen, & Dietz, 2009). The need to find solutions to improve the health of Americans is clear and communities are called to respond. The Centers for Disease Control and Prevention (CDC, 2018) recommends partnership with local agencies to promote obesity prevention initiatives and create a healthier …

School-Based Interventions To Promote Personal And Environmental Hygiene Practices Among Children In Pakistan: Protocol For A Mixed Methods Study, Nousheen Pradhan, Waliyah Mughis, Tazeen S. Ali, Maleeha Naseem, Rozina Karmaliani Professor

Community Health Sciences

Background: Poor personal hygiene and inadequate sanitation practices among young children leads to communicable diseases. There remains a gap in the holistic assessment of school children's hygiene literacy, practices and effectiveness of school-based hygiene interventions in Pakistan. Therefore, a school-based intervention protocol has been designed to promote personal and environmental hygiene practices for primary school children. Towards improving children's hygiene behaviors, the study will also focus on enhancing mothers' hygiene knowledge and practices.
Methods: Using quasi-experimental design with mixed methods data collection approaches, this study will be conducted in schools located in an urban squatter settlements in Pakistan. To assess …

Planting The Seeds Of Health And Resilience, Shawna Beese, Teresa Bigand, Marian L. Wilson

Articles, Abstracts, and Reports

Purpose/Aims:

Our primary aim was to investigate whether gardens were a source of nutrition for the food bank users we sampled, and whether food bank recipients would be interested in using gardens as a nutritional resource.

Rationale/Background:

Food bank users represent an important population to explore the benefits of garden access for because they are at risk for insufficient access to fresh nutrient dense foods, may benefit from a low cost alternative sources of food, and they experience higher incidence of food insecurity. The activity of gardening also provides a myriad of secondary health benefits such as elevating mood, easing …

Increasing Healthy Lifestyle Behaviors In Cargo Drivers, Ronda L. Bell

Electronic Theses and Dissertations

The purpose of this project was to examine the extent to which lifestyle behaviors of transportation drivers in North Texas can be improved with health education. This research study was conducted to examine the health behaviors of transportation drivers as a result of an educational partnership between nursing and the transportation industry. The goal was to improve healthy lifestyles through education to decrease chronic illness and comorbid conditions of a significantly at-risk occupational population. The impact of this education was immediate and verified with quantitative measurement and statistical analysis. Results demonstrated that after nurse-led health education, transportation drivers reported significant …

Community Outreach And Education Project: Hepatitis A And B Vaccines In High Risk Populations, Ellen Wright

Master of Science in Nursing Theses and Projects

The Community Outreach and Education Project targets high risk groups within Gaston County to increase education and vaccination against Hepatitis to, in turn, lower countywide Hepatitis rates. Through implementation of the project, Gaston County Department of Health and Human Services-Public Health (GCDHHS-PH) will partner with Community sponsors to gain access to their high-risk clients. Sponsors will be educated on the impact of prompt intervention in slowing the spread of hepatitis throughout high risk groups. Once an agreement is made between GCDHHS-PH and Community sponsors, GCDHHS-PH will present to participating facilities and begin screening, educating, and vaccinating high-risk individuals.

The George Floyd Of Healthcare, Sheila P. Davis, Phd, Fnp-C, Faan, Lsm-Bc, Gary Davis, Md

Journal of Health Ethics

Authors explore the infamous murder of an unarmed black man, George Floyd, and juxtaposition it to systemic racial practices in healthcare as documented by the Institute of Medicine Report: Unequal Treatment. The current COVID-19 pandemic is presented as a situation which has the potential to ignite unresolved discriminatory healthcare practices. Proposed are policies which could possibly mitigate this phenomenon.