Community Health and Preventive Medicine Commons^™

Offering Medical Providers Capacity And Competence In Caring For Transgender And Non-Binary Patients: Evaluation Of A Pilot Digital Training Program, Lexis Manzara

Master's Projects and Capstones

Purpose: Stigma and discrimination in health care settings contribute to health disparities for transgender and non-binary (TGNB) people. Evidence suggests that a lack of training on the care for transgender and non-binary TGNB patients in medical school curricula has contributed to providers feeling unprepared to provide quality care for this population. Health care providers have the opportunity to play a key role in the reduction of health disparities for TGNB patients.

Methods: Twenty-five health care providers completed the eight-module digital training program. Pre- and post-tests assessed provider knowledge, self-efficacy, preparedness, and behavior. Paired samples t-tests were conducted to compare pre-and …

Art-Based Health Education For Homeless And Marginally Housed Women In San Francisco, Trineca R-N Godfrey

Master's Projects and Capstones

San Francisco currently has the highest rate of unsheltered homeless persons in the United States. Between limited resources and stigma many women included in this most vulnerable population are left with little to no support. Cis women as well as trans and non- binary people are at high risk for negative mental health outcomes due to violence (physical and psychological), stigma, lack of social support, societal marginalization, and the lack of healthcare. Lyon-Martin Health Services and the Women’s Community Clinic, in San Francisco’s Mission Neighborhood, caters to this community through its Outreach Department. Following a staff and outreach client needs …

Redefining Trauma: Utilizing Restorative Justice To Repair Care Systems, Emebet Aklilu

Master's Projects and Capstones

This project examined the ways in which restorative justice programming can improve trauma informed care among the African American population in Oakland, CA. With 23% of African American men and women living at or below the poverty line in the United States, this project assesses gaps in current trauma informed care practices as evident in the literature. Following a rigorous document review the author coded and organized key programming components following six factors detailed by Rowher, Schoones, and Young (2014). Further examination of these program components was conducted using Bloom’s taxonomy levels to assess program outcomes associated with specific modules …

Effectiveness Of Community Outreach Hiv Prevention Programs In Vietnam: A Mixed Methods Evaluation, Lora L. Sabin, Katherine Semrau, Mary Bachman Desilva, Le T T Loan, Jennifer J. Beard, Davidson H. Hamer, Jordan Tuchman, Ted Hammett, Nafisa Halim, Manisha Reuben, Aldina Mesic, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background

In 2014, Vietnam was the first Southeast Asian country to commit to achieving the World Health Organization’s 90–90-90 global HIV targets (90% know their HIV status, 90% on sustained treatment, and 90% virally suppressed) by 2020. This pledge represented further confirmation of Vietnam’s efforts to respond to the HIV epidemic, one feature of which has been close collaboration with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Starting in 2004, PEPFAR supported community outreach programs targeting high-risk populations (people who inject drugs, men who have sex with men, and sex workers). To provide early evidence on program impact, …

Wellness For One, Healthy Community For All: Improving A Multidimensional University Wellness Programlth, Shea Gaier

Master's Projects and Capstones

Background: Evidence suggests that college students are often unaware of the seven

dimensions of wellness (Social, emotional, environmental, financial, physical, intellectual, and spiritual). According to interviews, most students think of physical wellness only when it comes to wellness. Besides the dimensions of wellness, students have shown to gain substantial benefits from increasing their knowledge of school resources regarding personal health.

Methods: This was a quality improvement project for the Wellness Matters Program that encompassed a Plan, Do, Study, Act cycle. The goal was to improve the program by adding a comprehensive educational workshop and optimizing the one-on-one sessions. Pilot tests …

Paging Dr. Strong: A Call To Action Towards Addressing Occupational Stress And Burnout Among Primary Care Health Professionals, Carmen Olmedo

Master's Projects and Capstones

Purpose: Within a rapidly evolving industry, occupational stress and burnout among healthcare clinicians and staff is becoming a pervasive public health crisis across all subspecialties. The purpose of this project was to use the Compassion Satisfaction-Compassion Fatigue (CS-CF) Theory as a method to assess burnout among primary care health professionals, in addition to developing recommendations to assist the promotion of a staff wellness initiative at an urban community clinic.
Methods: A needs assessment was conducted at a Community Health Center (CHC) in San Francisco. Data collection consisted of anonymous distribution of the Professional Quality of Life (ProQOL) Survey and semi-structured …

Building Financial Management Capacity For Community Ownership Of Development Initiatives In Rural Zambia, Viviane Sakanga, Parker S. Chastain, Kathleen L. Mcglasson, Jeanette L. Kaiser, Misheck Bwalya, Melvin Mwansa, Kaluba Mataka, David Kalaba, Nancy Scott, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: Building financial management capacity is increasingly important in low- and middle-income countries to help communities take ownership of development activities. Yet, many community members lack financial knowledge and skills.

Methods: As part of a larger health intervention, we designed and conducted financial management training for 83 members from 10 community groups in rural Zambia. Change scores between pre- and post-tests on financial knowledge were calculated and multivariate linear regression models run. Qualitative feedback was elicited.

Results: The training significantly improved knowledge of financial concepts. Participants with some or more than some secondary education had greater improvements …

Adolescent Sexual Reproductive Health Course: A Mixed Media Intervention And Quality Improvement Project In A School-Based Setting, Stephanie Calabrese

Doctor of Nursing Practice (DNP) Projects

Section I: Abstract

Problem: California’s adolescents carry a significant burden of newly acquired sexually transmitted infections (STIs) and gaps in adolescent sexual and reproductive health (SRH) knowledge have led to poor adolescent health outcomes. (CDE, 2019). Context: The California Healthy Youth Act (AB 329) was enacted on January 1, 2016, calling all school districts to ensure that all pupils receive comprehensive sexual health education, and HIV prevention education (CDE, 2019). In a proactive motion, parents from a northern California middle school approached a university to provide a Doctor of Nursing Practice (DNP) student to instruct its sixth grade’s …

Enhancing Nutrition Education For School Aged Children; A Preventive Health Measure And Quality Improvement Project, Fanny M. Powell

Doctor of Nursing Practice (DNP) Projects

Objective: The purpose of the DNP project was to improve nutritional knowledge of the adolescents at Kings Canyon Unified School District while also improving their perceived ability to choose healthy food. This project was enveloped in a larger community outreach mission utilizing a free school-based clinic for the purposes of providing sports physicals to students and health screening and physicals to the community. Additionally, nurse practitioner students engaged in a cultural immersion experience through clinical rotations in Central Valley.

Methods: Adolescent students who registered for the clinic watched a nine-minute nutrition video, created by the DNP student, while waiting …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Finding The Narrative In Incident Reports, La'eeqa Aslam

Master's Projects and Capstones

The Progress Foundation, as licensed by the state of California and the Community Care Licensing, is required to use incident reports for internal audits and remain in compliance as a health facility. Incident reports are used to record events or accidents that have occurred within an organization. Often times, reports are made, handed off, and given from the residence home to the Community Care Licensing with little to no information of how an incident was managed. The Progress Foundation is working towards tracking information from the incident reports to improve internal management and understand the trends in the reports.

In …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

In Home Support For All: A Community Outreach Project, Lily Moll

Master's Projects and Capstones

Abstract

In Home Supportive Services Public Authority (IHSSPA) is a Medi-Cal funded organization that helps the elderly and disabled living in San Francisco find care and support at home. The Public Authority component of IHSS specializes in providing support to their clients or “consumers” when attempting to hire home care workers or “providers.” However, IHSSPA services remain relatively unknown throughout many communities in San Francisco county and there is a need for increased community outreach. To address this problem, communities that are currently underserved by IHSSPA were defined by their zip code. These communities were compared with data indicating which …

Implementation Of A Fruit And Vegetable Voucher Program In San Francisco, Alexandra Kambur

Master's Projects and Capstones

Chronic disease has emerged as the predominant public health challenge of the 21st century. Chronic diseases like cardiovascular disease, cancer, type 2 diabetes and obesity have maintained their top positions as the leading causes of poor health, disability, death, and high health-care expenditures for over a decade. Health and hunger go hand-in-hand. Today over 15 million households in the United States struggle with food insecurity, meaning they do not have sufficient access to food that meets their dietary needs for an active and healthy life. The issue of food insecurity in cities like San Francisco, California is exacerbated by the …

Increasing Empathy And Conflict Resolution Skills Through Nonviolent Communication (Nvc) Training In Latino Adults And Youth, Marcianna Nosek, Maite Durán

Nursing and Health Professions Faculty Research and Publications

Background: Children of Latino immigrants often are torn between their native homes and new communities. Having supportive interpersonal relationships increases resilience to delinquent and violent behaviors stemming from immigration challenges. Communication fostering empathy may improve conflict resolution and supportive relationships.

Objectives: Community-based participatory research (CBPR) was conducted to evaluate the impact of nonviolent communication (NVC) trainings in Latino adults and youth.

Methods: Four sessions in NVC were provided by bilingual Latino trainers for Latino adults and youth. Pre- and post-training focus groups evaluated effectiveness of training.

Results: Three themes emerged from adult post training focus groups—enter the others’ shoes, making …

Community-Based Asthma Intervention Programs And Their Impact On Childhood Health Outcomes And Burdens On The Healthcare System, Danika Ng

Master's Projects and Capstones

Since 1997, asthma prevalence rates have increased by 3% annually, leading to a current rate of 18.4 million adults and 6.2 million children with asthma, high hospitalization and emergency department visit rates, and an overall healthcare spending of 50 billion dollars. However, this increase in prevalence is disproportionately impacting children. Asthma is the third leading cause for hospitalization in children, have higher proportions of children being hospitalized with asthma symptoms, and have higher rates of asthma attacks. Recent literature shows that perceived lack of adequate education in areas such as medication adherence, medical device usage, asthma trigger avoidance, lack of …

Optimizing Hiv Prep Implementation In The Primary Care Setting, Cara P. Nalagan

Doctor of Nursing Practice (DNP) Projects

Despite compelling evidence behind the efficacy of pre-exposure prophylaxis (PrEP) in preventing human immunodeficiency virus (HIV) acquisition and its introduction in 2012, the prescription of PrEP has remained low (Silapaswan, Krakower, & Mayer, 2016). At the Asian and Pacific Islander Wellness Center (API), an urban primary care clinic in San Francisco, suboptimal PrEP implementation was related to a lack of standardized practice and routine HIV risk screening for PrEP provision. A doctorate of nursing (DNP) project was implemented to initiate a standardized HIV risk screening protocol for identifying HIV risk and PrEP eligibility to increase PrEP implementation at API. The …

The Health Consequences Of Adverse Childhood Experiences: Building Resilient Communities, Elizabeth S. Najmabadi

Master's Projects and Capstones

Studies have identified that trauma experienced as a child directly affects your health later in life. In Sonoma County, one in four children have experienced two or more Adverse Childhood Experiences (ACEs) before the age of 18. Twenty-two percent of Sonoma County adults reported experiencing four or more ACEs before the age of 18. With the high rates of ACEs in our community this fieldwork placement aimed to bring awareness and build community capacity to understand and address ACEs and foster resiliency. To raise awareness in our community we developed the ACES and Resiliency Fellowship Series, which trained 60 fellows …

The Impact Of Housing Insecurity On Community Health Outcomes: Exploring Collective Community Solutions And Housing Models In The Western Addition, Jacqueline V. Brown, Jacqueline Victoria Brown

Master's Projects and Capstones

In a city where housing is scarce and prices continue to rise, the lower income residents of the Western Addition are in panic. Historically, the Western Addition/Fillmore is ground zero for Urban Renewal. This community is still bouncing back from the negative effects of the out migration of Black residents, Japanese internment, and rapid gentrification. For twenty years, this part of the city was known as Harlem of the West due to its world-renowned Jazz and Blues composers, and is informally known as “Tha ‘Mo”. San Francisco has set the tone nationally for public, mixed income, and private housing that …

Inpatient & Outpatient Venous Thromboembolism: A Multifactorial Approach To Increase Mechanical And Pharmacological Prophylaxis Compliance, Suzanne E. Scheierling

Master's Projects and Capstones

Venous thromboemboli (VTEs) are a clinical and public health problem as they are commonly linked to inpatient experiences, yet frequently occur in the outpatient setting. VTEs place a significant burden on health care organizations and patients alike, as VTEs are costly, require long-term medications, and frequently reoccur. Research has identified risk factors and determined best practices for VTE prevention and prophylaxis, however little consensus exists among health care organizations and the implementation of best practices is varied. This project studied the challenges and opportunities in VTE prevention and prophylaxis at a large metropolitan hospital in California. Environmental changes were made …

Do Marketing Strategies Impact Condom Sales In Uganda?, Meyhar Mohammed

Master's Theses

What attracts people to buy condoms? HIV/AIDS remain one of the biggest health dangers of the world, especially in Sub-Saharan Africa. A lot of efforts have been pursued in the past two decades to drastically reduce prevalence of HIV and increase awareness about preventive mechanisms. In order to prevent relapse of success achieved so far, it is important to recognize transformation of consumer behavior due to growth in social networks, education and awareness over time. There are a lot of behavioral triggers captured by social marketing interventions in the field of public health. In an attempt to investigate the role …

The Healing Power Of A Whole Foods, Plant-Based Diet: A Nutrition Prescription For Cancer, Meghan Adelman Mrs.

Master's Projects and Capstones

Chronic disease is quickly overtaking infectious diseases as one of the biggest threats to population health worldwide (Egger, 2012). Studies have shown that plant based diets are effective at reducing prevalence but are also a viable complimentary treatment approach to healing. Further investigation is needed into how plant based diets can reduce risk of recurrence, specifically as it relates to a cancer diagnosis. The Ceres Project is an organization that provides a healing foods philosophy to the care of cancer patients through meal delivery programs at low to no cost. The aim of this research study was to implement the …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

Chna: The Role Of The Hospital In Addressing Specific Community Health Needs, Yesmina L. Zavala

Master's Projects and Capstones

The Patient Protection and Affordable Care Act (ACA) added a requirement for nonprofit hospitals to keep their tax-exempt status under the Internal Revenue System Code 501(c) 3. This code requires all nonprofit hospitals to complete Community Health Needs Assessment (CHNA) reports every three years and must include input from community stakeholders and underserved individuals representing the low-income, minority and chronically ill population.

In addition to the CHNA, implementation strategies are required to be executed in the geographic areas served in order to meet the identified prioritized needs from the CHNA. Oftentimes, CHNAs are difficult to conceptualize and operationalize within the …

Geographical Incidence Of Antimicrobial Resistant Gonorrhea, Christofer A. Rodriguez

Master's Projects and Capstones

Evolving throughout the last century, Gonorrhea has become a superbug, becoming difficult to treat. As the second most commonly reported notifiable disease, gonorrhea rates have been increasing, despite efforts in prevention and treatment. Populations at risk are mainly MSM and FSW. In 2015, men’s gonorrhea rates in the United States were higher compared to women, at 140.9 and 107.2 per 100,000 population, respectively. Illinois has consecutively had higher rates of infection compared to the US, at 133.5 per 100,000 population compared to the US rate of 123.9 per 100,000 population. The surveillance of gonococcal isolate resistance to current antimicrobials began …

Inside The Juvenile Justice System, Megan Phalon

Master's Projects and Capstones

The United States of America is known for freedom and integrity and being a nation that stands for justice and equality for all. Within the United States there are systems in place to better the people and communities in order to provide safety and order. However, just as any nation, there is a struggle with violent behavior and tendencies among adults and adolescents. Within the last three decades, the United States has created a correctional system that specifically targets adolescents, and that acknowledges the differences between adult and juvenile development and deviant behavior. Within this literature review, academic databases were …

Exploring The Role Of Pharmacists In Management Of Hypertension In A Safety Net Clinic, Pandora Lau

Master's Projects and Capstones

Potrero Hill Health Center through the San Francisco Department of Public Health aims to deliver health promotion, disease prevention, heath maintenance, counseling, and health education of acute and chronic diseases. Hypertension is a common problem to both the health center and to the general population, and Potrero Hill Health Center aims to understand and develop a program that will aid in hypertension management at their local clinic. A supplemental pharmacist service was implemented at Potrero Hill Health Center to help manage hypertensive patients. Systolic and diastolic blood pressure levels were compared in patients receiving pharmacist counseling versus those receiving physician …

Quality Management: A Global Case Study In Organ Transplantation, Cassie L. Rodriguez

Master's Projects and Capstones

Every year the US and European countries face an epidemic of organ failure from a multitude of reasons: cancer, genetic predisposition, exposure to harmful chemicals in home or surrounding areas or through drinking, drugs and smoking. Another problem faced, is the ratio of organ donors to organ recipients. Over 121,000 patients are on the waiting for an organ transplant, and a fraction of those waiting will die because of time. The Hanover Medical school and department of quality management, have created an integrated approach to organ transplant avenues. Quality management is a systematic guide for organ transplantation that allows all …

Improving Data Collection To Reduce Maternal And Infant Mortality And Morbidity In Malawi: Evaluating Chimwemwe Mu'bereki, A Community Based Intervention, Alexandra E. H. Jones

Master's Projects and Capstones

Maternal and infant death rates in Malawi are among the highest in the world. Over 17 million people live in this small country in sub-Saharan Africa, where the country’s life expectancy is just 60.6 years (World Bank, 2015). These deaths can be attributed to many complex factors, including cultural practices, lack of adequate medical equipment, long travel distances to health facilities, low staffing at hospitals and clinics, extreme poverty, and malnutrition. Without government support and intervention, community groups must fill in the gaps to make needed improvements to maternal and infant health outcomes. African Mothers Health Initiative (AMHI) enrolls high …

Unicef Kid Power: Empowering Kids To Get Active And Save Lives, Emily L. Gudaitis

Master's Projects and Capstones

UNICEF Kid Power is a program aimed at increasing U.S. children’s activity levels by tapping into children’s intrinsic desire to do good. Through their activity levels, kids earn points, which unlocks funding from partners that will support treatment for a malnourished child. This one-of-a-kind program was implemented in the Bay Area in Spring 2016 with 7,800 youth participants. The attached paper is a summary of a 300-hour fieldwork experience at the U.S. Fund for UNICEF assisting with the UNICEF Kid Power implementation in the Bay Area. The fieldwork included program implementation and evaluation, presentations at participating schools in the area, …