Programs and Communities
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- All Subjects: Adolescent
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Background: Healthcare providers are encouraged to prepare their practice to effectively manage the care of mild to moderate adolescent depression. Cost-effective screening, diagnostic, and newly developed pediatric primary care depression management guidelines have been established. To integrate guidelines into practice, primary care providers (PCPs) must document effectively to ensure a complete treatment plan is in place in the patient’s electronic health record (EHR).
Intervention: Elements from a flowsheet were implemented into the EHR to promote thorough assessment and documentation of care delivered to adolescents with depression.
Methods: An initial chart review was completed on patients diagnosed with depression. An updated depression template was implemented within the EHR for six weeks. A follow-up chart review was completed post-intervention to determine if documentation of elements from the adolescent depression guidelines improved after the EHR update. Pre-intervention and post- intervention surveys were delivered to PCP’s to understand their perspective on adolescent depression management.
Outcomes: The chart review revealed that baseline PHQ-9 screenings were documented in 91% (n=43) of the charts reviewed in the pre-intervention timeframe. Only 78% (n=7) of the charts reviewed during post-intervention included PHQ-9 screenings. Early intervention treatment options documented in the pre-intervention timeframe included education 100% (n=47), medication prescriptions 53% (n=25), and psychotherapy referrals 18% (n=18). During post- intervention, education 100% (n=9), medication prescriptions 78% (7), and psychotherapy referrals 22% (n=7) were documented by the PCPs.
Recommendation: The quality improvement project focused heavily on documentation completed over a one year pre-intervention timeframe compared to a six-week post-intervention timeframe. Further evaluation and chart review over the next year will provide a more adequate comparison of documentation within primary care practice.
There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of youth who experience a major depressive disorder. Teachers and non-teaching staff are well placed in the community to identify youth undergoing emotional distress and facilitate early interventions, yet do not receive adequate training in mental health.
A project was undertaken to determine if a mental health training intervention affected the community youth mentors knowledge, attitude and self-efficacy towards helping youth with mental health issues. Three instruments with good validity and reliability namely Mental Health Literacy Scale (MHLS), Attitudes to Severe Mental Illness (ASMI) scale, and Gatekeeper Behavior Scale were used in pre intervention, immediately post intervention and two weeks post intervention questionnaires. The Wilcoxon Signed Ranks test indicated changes in the pre and post intervention scores as significant in knowledge, and attitude between pre intervention and immediately post intervention time periods. Cohen’s effect size value suggested large, medium, small, and minimum clinical significance in the variables over period of time.
Mental health literacy narrows the gap between symptom onset and intervention. Numerous mental health trainings are currently available worldwide. Schools and after school clubs in collaboration with hospital mental health and other community agencies are better equipped to bridge the gap. School staff report better confidence in addressing mental health and behavioral health issues among youth when equipped with additional resources within the school in the form of psychologists, social workers, and counselors.
The New Jersey Childhood Obesity Study, funded by the Robert Wood Johnson Foundation, aims to provide vital information for planning, implementing and evaluating interventions aimed at preventing childhood obesity in five ew Jersey municipalities: Camden, Newark, New Brunswick, Trenton, and Vineland. These five communities are being supported by RWJF's New Jersey Partnership for Healthy Kids program to plan and implement policy and environmental change strategies to prevent childhood obesity.
Effective interventions for addressing childhood obesity require community specific information on who is most at risk and on contributing factors that can be addressed through tailored interventions that meet the needs of the community.
Using a comprehensive research study, the Center for State Health Policy at Rutgers University is working collaboratively with the State Program Office for New Jersey Partnership for Healthy Kids and the five communities to address these information needs. The main components of the study include:
• A household survey of 1700 families with 3 -18 year old children
• De-identified heights and weights data from public school districts
• Assessment of the food and physical activity environments using objective data
Data books and maps based on the results of the study are being shared with the community coalitions in the five communities to help them plan their interventions.
The maps in this chartbook describe the food environment in Vineland in terms of access to supermarkets, smaller grocery stores, convenience stores, and limited service restaurants. Research shows that when residents have access to healthy food outlets, they tend to eat healthy.
• Food environment maps were created using geo-coded commercially available data of food outlets (Info USA, 2008 and Trade Dimensions, 2008) in Vineland and in a 1 mile buffer area around Vineland.
•Using the commercial data and additional investigation, food outlets were classified into different categories based on their likelihood of carrying healthy choices: supermarkets carry most healthy choices; smaller grocery stores carry fewer healthy choices; convenience stores and limited service restaurants are likely to carry mostly unhealthy choices.
• Access to different types of food outlets was computed at the census block group level based on concentration of stores / restaurants per unit area and is reported as food outlet densities.
• Food outlet density maps are compared with Census 2000 data to visualize accessibility of healthy foods in neighborhoods with different characteristics.
Data Sources: Info USA food outlet 2008 data
Trade Dimensions food outlet 2008 data
Census 2000 data
New Jersey Department of Education 2008-2009 data
The maps in this chartbook describe the food environment in ewark in terms of access to supermarkets, smaller grocery stores, convenience stores, and limited service restaurants. Research shows that when residents have access to healthy food outlets, they tend to eat healthy.
• Food environment maps were created using geo-coded commercially available data of food outlets (InfoUSA, 2008 and Trade Dimensions, 2008) in Newark and in a 1 mile buffer area around Newark.
•Using the commercial data and additional investigation, food outlets were classified into different categories based on their likelihood of carrying healthy choices: supermarkets carry most healthy choices; smaller grocery stores carry fewer healthy choices; convenience stores and limited service restaurants are likely to carry mostly unhealthy choices.
• Access to different types of food outlets was computed at the census block group level based on concentration of stores / restaurants per unit area and is reported as food outlet densities.
• Food outlet density maps are compared with Census 2000 data to visualize accessibility of healthy foods in neighborhoods with different characteristics.
Data Sources: Info USA food outlet 2008 data
Trade Dimensions food outlet 2008 data
Census 2000 data
New Jersey Department of Education 2008-2009 data
The maps in this chartbook describe the food environment in Trenton in terms of access to supermarkets, smaller grocery stores, convenience stores, and limited service restaurants. Research shows that when residents have access to healthy food outlets, they tend to eat healthy.
•Food environment maps were created using geo-coded commercially available data of food outlets (InfoUSA, 2008 and Trade Dimensions, 2008) in Trenton and in a 1 mile buffer area around Trenton.
•Using the commercial data and additional investigation, food outlets were classified into different categories based on their likelihood of carrying healthy choices: supermarkets carry most healthy choices; smaller grocery stores carry fewer healthy choices; convenience stores and limited service restaurants are likely to carry mostly unhealthy choices.
• Access to different types of food outlets was computed at the census block group level based on concentration of stores / restaurants per unit area and is reported as food outlet densities.
•Food outlet density maps are compared with Census 2000 data to visualize accessibility of healthy foods in neighborhoods with different characteristics.
Data Sources: Info USA food outlet 2008 data
Trade Dimensions food outlet 2008 data
Census 2000 data
New Jersey Department of Education 2008-2009 data
The maps in this chartbook describe the food environment in Camden in terms of access to supermarkets, smaller grocery stores, convenience stores, and limited service restaurants. Research shows that when residents have access to healthy food outlets, they tend to eat healthy.
• Food environment maps were created using geo-coded commercially available data of food outlets (InfoUSA, 2008 and Trade Dimensions, 2008) in Camden and in a 1 mile buffer area around Camden.
•Using the commercial data and additional investigation, food outlets were classified into different categories based on their likeliliood of carrying healthy choices: supermarkets carry most healthy choices; smaller grocery stores carry fewer healthy choices; convenience stores and limited service restaurants are likely to carry mostly unhealthy choices.
• Access to different types of food outlets was computed at the census block group level based on concentration of stores / restaurants per unit area and is reported as food outlet densities.
•Food outlet density maps are compared with Census 2000 data to visualize accessibility of healthy food s in neighborhoods with different characteristics.
Data Sources: Info USA food outlet 2008 data
Trade Dimensions food outlet 2008 data
Census 2000 data
New Jersey Department of Education 2008-2009 data