Programs and Communities

Study Background: Researchers at ASU have determined that significant energy and environmental benefits are possible in the Phoenix metro area over the next 60 years from transit-oriented development along the current Valley Metro light rail line. The team evaluated infill densification outcomes when vacant lots and some dedicated surface parking lots are repurposed for residential development. Life cycle building (construction, use, and energy production) and transportation (manufacturing, operation, and energy production) changes were included and energy use and greenhouse gas emissions were evaluated in addition to the potential for respiratory impacts and smog formation. All light rail infill scenarios are compared against new single family home construction in outlying areas.

Overview of Results: In the most conservative scenario, the Phoenix area can place 2,200 homes near light rail and achieve 9-15% reductions in energy use and emissions. By allowing multi-family apartments to fill vacant lots, 12,000 new dwelling units can be infilled achieving a 28-42% reduction. When surface lots are developed in addition to vacant lots then multi-family apartment buildings around light rail can deliver 30-46% energy and environmental reductions. These reductions occur even after new trains are put into operation to meet the increased demand.

Better methods are necessary to fully account for anthropogenic impacts on ecosystems and the essential services provided by ecosystems that sustain human life. Current methods for assessing sustainability, such as life cycle assessment (LCA), typically focus on easily quantifiable indicators such as air emissions with no accounting for the essential ecosystem benefits that support human or industrial processes. For this reason, more comprehensive, transparent, and robust methods are necessary for holistic understanding of urban technosphere and ecosphere systems, including their interfaces. Incorporating ecosystem service indicators into LCA is an important step in spanning this knowledge gap.

For urban systems, many built environment processes have been investigated but need to be expanded with life cycle assessment for understanding ecosphere impacts. To pilot these new methods, a material inventory of the building infrastructure of Phoenix, Arizona can be coupled with LCA to gain perspective on the impacts assessment for built structures in Phoenix. This inventory will identify the origins of materials stocks, and the solid and air emissions waste associated with their raw material extraction, processing, and construction and identify key areas of future research necessary to fully account for ecosystem services in urban sustainability assessments. Based on this preliminary study, the ecosystem service impacts of metropolitan Phoenix stretch far beyond the county boundaries. A life cycle accounting of the Phoenix’s embedded building materials will inform policy and decision makers, assist with community education, and inform the urban sustainability community of consequences.

This study aims to quantify the environmental impacts of a hospital’s daily BMW disposal in the Phoenix, Arizona area. The sole option to dispose of BMW in Arizona is to sterilize the waste by sending it through an autoclave, and then dispose the sterilized waste in a landfill. This study used a Phoenix area hospital to create a start point for the waste and a general estimation of how much BMW the hospital disposes of. The system boundary for the LCA includes BMW generated at the Phoenix-area Hospital as it is travels to Stericycle, where it is autoclaved, and then transported to a landfill for disposal. The results of this retrospective, end-of-life LCA using this boundary enables hospital employees and policy makers to understand the environmental impact of placing items in the biohazardous waste bin.

Diabetes, a common chronic condition, effects many individuals causing poor quality of life, expensive medical bills, and devastating medical complications. While health care providers try to manage diabetes during short office visits, many patients still struggle to control their diabetes at home. Lack of diabetes self-management (DSM) is a potential barrier for people with diabetes having to maintain healthy hemoglobin A1cs (HgA1c).

In hopes of addressing this concern, an evidenced-based intervention; diabetic education and phone calls, using the chronic care model as its framework was implemented. The intervention targeted people with type II diabetes at a transitional care setting. Measured variables included HgA1c and DSM. Statistically significant improvements were seen in reported physical activity. Average improvements were seen in HgA1c and DSM after three months of diabetes self-management education (DSME). Attrition, cultural sensitivity, and increasing DSME hours should be further evaluated for future projects.

Background and Purpose: Over 30 million people in the United States (U.S.) have diabetes mellitus, which comprises about 9% of the population, and about 90% of individuals with diabetes have type 2 diabetes (Centers for Disease Control and Prevention [CDC], 2017). Adults with type 2 diabetes at a local internal medicine clinic were consistently having high glycated hemoglobin (HbA1C) levels, demonstrated by data collected from the electronic health record (EHR), and there was no ordering process for referring patients to diabetes management education and support (DSMES) services. The purpose of this project was to improve glycemic control, demonstrated by lower HbA1C levels, and reach a diabetes education attendance rate of 62.5% at an internal medicine clinic in Chandler, Arizona.

Methods: An electronic health record (EHR) template was created and brief staff training was completed to connect patients with diabetes in the community to a local formal diabetes education program. HbA1C levels were measured before and three months after adults with education program. HbA1C levels were measured before and three months after adults with type 2 diabetes mellitus (T2DM) received physicians’ orders for a DSMES program, and rates of attendance to the program were calculated. Data was collected through the EHR and through feedback from the DSMES program. Descriptive statistics were used in data analysis.

Outcomes: The participants’ results did not demonstrate significant differences in pre-referral and post-referral HbA1C results after they were ordered DSMES services (p = .506). The proportion of education attendance (30%) was lower than the project goal of 62.5%, but increased from the clinic baseline.

Conclusions: EHR template implementation for referral to DSMES may increase rates of formal diabetes education and improve glycemic control. Larger sample sizes, longer project periods, alternative methods of communication, and increased follow-up of participants may be required to produce significant results.

Background: The global prevalence of all types of diabetes increased from 108 million in 1980 to 422 million in 2014 (Nazir et al., 2018). The Centers for Disease Control and Prevention (2017) ranks diabetes as the 7th leading cause of death in the United States with an estimated annual expense of $327 billion. Within the rural setting, patients typically have less resources available for the treatment and self-management of their diseases. It is important to explore self-management techniques that can be utilized by patients with type 2 diabetes living in rural areas. Research demonstrating the importance of education, exercise, diet, glucose monitoring, medications, and supportive measures is prominent throughout the literature.

Objective: The purpose of this Doctor of Nursing Practice (DNP) applied project is to investigate the effects of delivering biweekly text messages containing diabetes self-management education (DSME) materials to patients in an effort to support successful self-care.

Methods: During an 8 week period, DSME was provided via text messaging, bi-weekly (Sunday and Wednesday), to 23 rural participants with type 2 diabetes, in a family clinic in Payson, Arizona. Participants were asked to complete the Skills, Confidence, and Preparedness Index both pre- and post-intervention to evaluate their knowledge of diabetes self-management.

Results: Twenty-three adults aged 52 to 78 years (M = 64.91) participated in the project. Of the participants, 57% (13/23) were female. The majority of participants had T2DM diagnosis less than 10 years (M=13.8 years). There was a statistical difference between the pre- and post-Skills, Confidence and Preparedness Index questionnaire (p < .001) indicating an improvement in self-efficacy scores post- intervention.

Conclusion: DSME delivered via text message is a cost-effective way to increase patients' self-efficacy and potentially improve their ability to successfully self-manage their disease.

Phoenix is the sixth most populated city in the United States and the 12th largest metropolitan area by population, with about 4.4 million people. As the region continues to grow, the demand for housing and jobs within the metropolitan area is projected to rise under uncertain climate conditions.

Undergraduate and graduate students from Engineering, Sustainability, and Urban Planning in ASU’s Urban Infrastructure Anatomy and Sustainable Development course evaluated the water, energy, and infrastructure changes that result from smart growth in Phoenix, Arizona. The Maricopa Association of Government's Sustainable Transportation and Land Use Integration Study identified a market for 485,000 residential dwelling units in the urban core. Household water and energy use changes, changes in infrastructure needs, and financial and economic savings are assessed along with associated energy use and greenhouse gas emissions.

The course project has produced data on sustainable development in Phoenix and the findings will be made available through ASU’s Urban Sustainability Lab.

Diabetes is a leading cause of morbidity in the world. About 42 million people worldwide have
diabetes. Poorly managed diabetes leads to long term complications and mortality. Diabetes self-management education (DSME) has been effective in preventing or delaying complications.The purpose of this project is to implement a diabetes self-management education (DSME)
program in primary care and to evaluate its impact on glycemic control and diabetes knowledge in a selected group of adults 18 years or older in a community-based practice.