Programs and Communities

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Patient Portal Utilization Effect on Patient Engagement

Description
Purpose: Patient portals are widely available online applications with many health-related tools that facilitate patient engagement and enhance communication with providers yet are highly underutilized. The purpose of this evidence-based practice (EBP) project was to explore an English and Spanish patient portal educational video's impact on patient engagement in a…

Purpose: Patient portals are widely available online applications with many health-related tools that facilitate patient engagement and enhance communication with providers yet are highly underutilized. The purpose of this evidence-based practice (EBP) project was to explore an English and Spanish patient portal educational video's impact on patient engagement in a Federally Qualified Health Center (FQHC). The social cognitive theory underpins the project because patients' portal use behavior can change if changing their environmental factors in the clinic with educational videos. Methods: The Universities Institutional Review Board granted exempt approval to ensure human subject protection. The participants included bilingual adult patients in an FQHC who have access to the internet and email addresses who visited the center during the implementation period. The tablets in the patient rooms displayed the English and Spanish educational video on step-by-step instructions on accessing, using the patient portal, and the benefits of use. The information technology technician pulled aggregate data from the analytics component of the patient portal before and after the four-week implementation period. The data included total number of clinic patients, number of active portal users, number of monthly logins, and gender. The project facilitator used descriptive statistics to compare pre-and post-intervention analytics. Results: Active portal users increased by 0.22% and monthly logins increased by 390 logins. Only aggregate data was collected so the statistical significance was not calculated. Conclusion: This EBP project enhances knowledge on patient portal utilization's impact on patient engagement and may apply to current practice.
ContributorsHerrera, M. Sara (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
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Building Awareness of the Medicare Annual Wellness Visit in Rural Healthcare

Description
Background/Objective: As a part of the Affordable Care Act of 2010, the Medicare Annual Wellness Visit (AWV) was intended to reduce health disparities and improve health outcomes through providing wellness visits for all Medicare recipients at no cost. However, adoption has been minimal since its inception, particularly in…

Background/Objective: As a part of the Affordable Care Act of 2010, the Medicare Annual Wellness Visit (AWV) was intended to reduce health disparities and improve health outcomes through providing wellness visits for all Medicare recipients at no cost. However, adoption has been minimal since its inception, particularly in rural populations Study Design: A top priority of a rural federally qualified healthcare organization (FQHC) was to improve utilization of the AWV due to a patient response well below the national average. A six-week trial was conducted that examined a patient information campaign combined with a strategic workflow that encouraged interoffice collaboration. Methods: The office staff of a pilot medical clinic was selected by the FQHC quality improvement committee as the project site. A Relational Coordination survey (RC) was administered before and after the intervention to determine if the intervention improved interoffice collaboration regarding the AWV. Descriptive questions were used to determine which aspects of the intervention proved useful. Reliability of the survey results was verified by a Crohnbach’s ? > 0.08. An independent samples t test was used with p value < 0.05 to determine statistical significance and confidence intervals. Results: The patient information brochure demonstrated improved patient understanding of the AWV from the office staff perspective as demonstrated by an independent samples t test comparing pre and post survey responses (t(32) = -4.14, p < .001, CI 95%). The RC survey results identified an area for collaborative for improvement between the front office and medical staff.
ContributorsSmith, J. Amanda (Author) / Morgan, Michelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
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Prenatal Care Education in an Urban, Underserved Population

Description
Background and Purpose: Across the United States, there are low adherence rates of prenatal care visits, primarily among the low-income and ethnic populations. Inadequate prenatal care education contributes to low appointment adherence and missed prenatal care during their first trimester. The project aim is to assess the current use of paper-based prenatal education…

Background and Purpose: Across the United States, there are low adherence rates of prenatal care visits, primarily among the low-income and ethnic populations. Inadequate prenatal care education contributes to low appointment adherence and missed prenatal care during their first trimester. The project aim is to assess the current use of paper-based prenatal education in a Federally Qualified Health Center (FQHC) in southwestern Arizona and inquire if patients would elect to engage in a phone application for prenatal education with appointment reminders. Approach/Methods: The Theory of Planned Behavior was the theoretical framework utilized to guide this project. The Quality Improvement (QI) project gathered information regarding patient technology use and accessibility as well as utilization of FQHC prenatal booklet, collected with a 13-question survey. A non-identifying demographic questionnaire was also distributed during the prenatal visit. Results: Survey responses indicated that patients find utility in prenatal education and appointment reminders provided through a phone application. Out of the total participants (n=23), only 18 had received the prenatal care booklet and completed the entire survey. 80% of participants expressed they would use the phone application while 84% find prenatal education on the phone helpful. In comparison, less than 28% of respondents planned to continue to use the prenatal booklet they were provided at the clinic during their pregnancy. Outcomes: There is potential in utilizing digital platform and appointment reminders at FQHC to improve appointment adherence and early entry to prenatal care. The results will be used to inform FQHC on decisions regarding continuing prenatal booklet use and integration of techbased education formatting.
ContributorsAlexander, Yana (Author) / Janicek, Patricia (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
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Diabetes Management Knowledge and Behavior Change Amongst At-risk Women

Description
Background: People with diabetes are at greater risk for comorbid cardiovascular disease, end stage organ damage, disability, and early death. There is substantial evidence that individualizing self-care education, such as eating a healthy diet, greatly improves diabetes management. Objective: The purpose of this paper is to review the…

Background: People with diabetes are at greater risk for comorbid cardiovascular disease, end stage organ damage, disability, and early death. There is substantial evidence that individualizing self-care education, such as eating a healthy diet, greatly improves diabetes management. Objective: The purpose of this paper is to review the outcomes of a diabetes education program offered to underserved women in the Southwestern United States. Methods: Four weekly nutrition classes were individualized and taught at a nonprofit organization in the southwest United States. Behavior change was measured using the Summary of Diabetes Self-Care Activities (SDSCA) tool. Classes were advertised via the center’s monthly class calendar and fliers. A total of nine participants (N=9) came to every class and took the SDSCA survey before and after class instruction. Results: Descriptive statistics and two 2-tailed t-tests with the critical value set at p<0.05 were used for data analysis. The participants were Hispanic women, most between the ages of 40-49, and had an income between $0-14,000. The mean difference between the variables of both general diet and specific diet pre and post-tests were significantly different from zero. The assumptions of normality and homogeneity were met. The results of both two-tailed paired sample t-tests were significant suggesting the means of general and specific diet pre-tests were significantly lower than the means of the general and specific diet post-tests. Discussion: The assumptions of normality and homogeneity were met and the results were significant. The pre-intervention scores for both categories were statistically significantly lower than the post-intervention scores for both categories. Thus, the desired outcome of helping clients within the organization modify, adapt, or change self-care behaviors related to diet was met.
ContributorsGandee, Marisol (Author) / Chiffelle, Rochelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-26
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Modality Retention in Peritoneal Dialysis

Description
Background: The cost of health care for end-stage kidney disease patients has exponentially increased over the years, costing 91,000 annually per patient. Peritoneal dialysis has proven to be a cost-effective renal replacement therapy compared to in-center hemodialysis. Quality evidence from a systematic literature review indicates that peritonitis is one of…

Background: The cost of health care for end-stage kidney disease patients has exponentially increased over the years, costing 91,000 annually per patient. Peritoneal dialysis has proven to be a cost-effective renal replacement therapy compared to in-center hemodialysis. Quality evidence from a systematic literature review indicates that peritonitis is one of the leading causes of patients' ability to maintain peritoneal dialysis. Evidence suggests that enhanced patient education on infection control practices beyond standard education effectively reduces peritonitis incidents. Methods: Enhanced education on infection control practices was delivered to 18 peritoneal dialysis patients in Southern Arizona through the application of determinants of the Health Belief Model utilizing the principles of the ADKAR framework. Data analysis will be available through facility-specific quality metrics of decreased peritonitis and modality loss episodes. Each of these measures is to have data compared to pre/post-intervention. Results: All participants in the study were able to sustain peritoneal dialysis as their renal replacement therapy. Of the 18 participants, one patient episode of peritonitis occurred three months before the intervention, and zero episodes were reported during the first three months of monthly infection control education. Facility-specific peritonitis and modality loss measures are not available until after project publication. Conclusion: To decrease peritonitis rates and modality loss, the intervention will continue for eight to 12 months to determine success. More time is needed to determine if patients adhere to monthly infection control practices taught during enhanced education.
ContributorsSchneeweis, A. Danielle (Author) / Rauton, Monica (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-29

A Sustainability Analysis of Workforce Housing Development Tools

Description
Arizona and the Phoenix metropolitan area are experiencing a housing crisis, both in terms of affordability and supply. While the number of affordable and available units has been shrinking, a separate trend has emerged that is also adding pressure to the housing market, particularly for renters—a demand for transit-oriented, walkable,…

Arizona and the Phoenix metropolitan area are experiencing a housing crisis, both in terms of affordability and supply. While the number of affordable and available units has been shrinking, a separate trend has emerged that is also adding pressure to the housing market, particularly for renters—a demand for transit-oriented, walkable, sustainable communities. As governments invest in projects and infrastructure falsely branded as sustainable, environmental gentrification often occurs resulting in displacement of current residents. Without new, moderately priced housing being built, displaced residents remain housing cost burdened. Workforce housing, priced to serve lower-middle to middle-income residents, offers a release from the pressure on the housing market, but innovative models for workforce housing development are necessary to navigate the regulatory and financial barriers in place. During a Solutions Round Table event facilitated by my client, a variety of potential tools for mitigating the housing crisis and removing barriers to workforce housing development were discussed. Based on conversations documented during the event, a robust list of workforce housing development tools was created. With the help of my client, the list was winnowed down to six tools for focused research—off-site construction, cohousing, land banks, missing middle infill models, community land trusts combined with limited equity cooperatives, and public-private partnerships. This project describes these tools and outlines best practices for developing and implementing them in the Valley. The best practices are organized to serve as guidance for the private sector and public sector separately, and for embedding health and social equity. Each tool is assessed using a simplified version of Gibson’s (2006) sustainability criteria, combined into four dimensions—environment, social, economic, and holistic. The findings from the assessment are embedded as guidance throughout the final product, a white paper, which will be delivered to Urban Land Institute (ULI) Arizona District Council Task Force for Health, Equity, and Housing Affordability, my client for this project.
ContributorsVan Horn, Elizabeth (Writer of accompanying material)
Created2020-05-26

Electric Transportation Equity in the Valley

Description

The electric transportation (ET) and electric vehicle (EV) landscape is currently inequitable and inaccessible for many living in the Phoenix area. This is especially true for people without single-occupancy vehicles (SOVs), who are reliant on public transit, or do not live in the Metropolitan center. Transit is intricately related to…

The electric transportation (ET) and electric vehicle (EV) landscape is currently inequitable and inaccessible for many living in the Phoenix area. This is especially true for people without single-occupancy vehicles (SOVs), who are reliant on public transit, or do not live in the Metropolitan center. Transit is intricately related to the environment and, due to societal and political structures, most of these environmental injustices are concentrated in low-income and minority communities. The lack of political representation within these communities has led to increased exposure to a variety of issues. Equitable transportation has also suffered due to a significant gap in addressing the needs of these underserved communities (Bolin, et al., 2005). The concentration of inequities and environmental injustices is a direct result of the lack of representation. Therefore, equitable and inclusive collaboration on solutions is required in order to maintain fairness and access, (Clement, 2020) considering the legacy of institutional harm within historically marginalized communities. The TE Activator was created by Salt River Project (SRP) and Anthesis Group, a sustainability consulting agency. The Activator is a group of Phoenix-area organizations interested in shaping the ET landscape to positively influence the well-being of Arizonans. With this in mind, they have asked our team to focus on making the transition to electric transportation equitable and inclusive. Our report details the current state of electric transportation nationally and locally, analyzes equitable EV/ET programs and utility plans across the country, and reviews the City of Tempe’s electric transportation related efforts. For this, we conducted listening sessions with a national expert, the City of Tempe, Tempe Community Action Agency, and CHISPA, creating a Community Listening Pilot Project based on the preliminary listening sessions. Through our research, listening, and discussions we compiled tiered recommendations for the TE Activator that suggest systemic policy changes based on community priorities. Accompanying the report is an Equity Roadmap, Community Listening Script, and one-page Debrief.
ContributorsBartholomew, Anna (Author) / Fielding, Raven (Author) / Logan, Grace (Author) / Shufeldt, Kaleigh (Author) / Stivers, John (Author)
Created2022-04
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Electric Transportation Equity in the Valley: Transportation Electrification Activator Team Brief

Description

The electric transportation (ET) and electric vehicle (EV) landscape is currently inequitable and inaccessible for many living in the Phoenix area. This is especially true for people without single-occupancy vehicles (SOVs), who are reliant on public transit, or do not live in the Metropolitan center. Transit is intricately related to…

The electric transportation (ET) and electric vehicle (EV) landscape is currently inequitable and inaccessible for many living in the Phoenix area. This is especially true for people without single-occupancy vehicles (SOVs), who are reliant on public transit, or do not live in the Metropolitan center. Transit is intricately related to the environment and, due to societal and political structures, most of these environmental injustices are concentrated in low-income and minority communities. The lack of political representation within these communities has led to increased exposure to a variety of issues. Equitable transportation has also suffered due to a significant gap in addressing the needs of these underserved communities (Bolin, et al., 2005). The concentration of inequities and environmental injustices is a direct result of the lack of representation. Therefore, equitable and inclusive collaboration on solutions is required in order to maintain fairness and access, (Clement, 2020) considering the legacy of institutional harm within historically marginalized communities. The TE Activator was created by Salt River Project (SRP) and Anthesis Group, a sustainability consulting agency. The Activator is a group of Phoenix-area organizations interested in shaping the ET landscape to positively influence the well-being of Arizonans. With this in mind, they have asked our team to focus on making the transition to electric transportation equitable and inclusive. Our report details the current state of electric transportation nationally and locally, analyzes equitable EV/ET programs and utility plans across the country, and reviews the City of Tempe’s electric transportation related efforts. For this, we conducted listening sessions with a national expert, the City of Tempe, Tempe Community Action Agency, and CHISPA, creating a Community Listening Pilot Project based on the preliminary listening sessions. Through our research, listening, and discussions we compiled tiered recommendations for the TE Activator that suggest systemic policy changes based on community priorities. Accompanying the report is an Equity Roadmap, Community Listening Script, and one-page Debrief.
ContributorsBartholomew, Anna (Author) / Fielding, Raven (Author) / Logan, Grace (Author) / Shufeldt, Kaleigh (Author) / Stivers, John (Author)
Created2022-04
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Electric Transportation in the Valley: Community Listening Script

Description

The electric transportation (ET) and electric vehicle (EV) landscape is currently inequitable and inaccessible for many living in the Phoenix area. This is especially true for people without single-occupancy vehicles (SOVs), who are reliant on public transit, or do not live in the Metropolitan center. Transit is intricately related to…

The electric transportation (ET) and electric vehicle (EV) landscape is currently inequitable and inaccessible for many living in the Phoenix area. This is especially true for people without single-occupancy vehicles (SOVs), who are reliant on public transit, or do not live in the Metropolitan center. Transit is intricately related to the environment and, due to societal and political structures, most of these environmental injustices are concentrated in low-income and minority communities. The lack of political representation within these communities has led to increased exposure to a variety of issues. Equitable transportation has also suffered due to a significant gap in addressing the needs of these underserved communities (Bolin, et al., 2005). The concentration of inequities and environmental injustices is a direct result of the lack of representation. Therefore, equitable and inclusive collaboration on solutions is required in order to maintain fairness and access, (Clement, 2020) considering the legacy of institutional harm within historically marginalized communities. The TE Activator was created by Salt River Project (SRP) and Anthesis Group, a sustainability consulting agency. The Activator is a group of Phoenix-area organizations interested in shaping the ET landscape to positively influence the well-being of Arizonans. With this in mind, they have asked our team to focus on making the transition to electric transportation equitable and inclusive. Our report details the current state of electric transportation nationally and locally, analyzes equitable EV/ET programs and utility plans across the country, and reviews the City of Tempe’s electric transportation related efforts. For this, we conducted listening sessions with a national expert, the City of Tempe, Tempe Community Action Agency, and CHISPA, creating a Community Listening Pilot Project based on the preliminary listening sessions. Through our research, listening, and discussions we compiled tiered recommendations for the TE Activator that suggest systemic policy changes based on community priorities. Accompanying the report is an Equity Roadmap, Community Listening Script, and one-page Debrief.
ContributorsBartholomew, Anna (Author) / Fielding, Raven (Author) / Logan, Grace (Author) / Shufeldt, Kaleigh (Author) / Stivers, John (Author)
Created2022-04
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Electric Transportation in the Valley: Equity Roadmap

Description

The electric transportation (ET) and electric vehicle (EV) landscape is currently inequitable and inaccessible for many living in the Phoenix area. This is especially true for people without single-occupancy vehicles (SOVs), who are reliant on public transit, or do not live in the Metropolitan center. Transit is intricately related to…

The electric transportation (ET) and electric vehicle (EV) landscape is currently inequitable and inaccessible for many living in the Phoenix area. This is especially true for people without single-occupancy vehicles (SOVs), who are reliant on public transit, or do not live in the Metropolitan center. Transit is intricately related to the environment and, due to societal and political structures, most of these environmental injustices are concentrated in low-income and minority communities. The lack of political representation within these communities has led to increased exposure to a variety of issues. Equitable transportation has also suffered due to a significant gap in addressing the needs of these underserved communities (Bolin, et al., 2005). The concentration of inequities and environmental injustices is a direct result of the lack of representation. Therefore, equitable and inclusive collaboration on solutions is required in order to maintain fairness and access, (Clement, 2020) considering the legacy of institutional harm within historically marginalized communities. The TE Activator was created by Salt River Project (SRP) and Anthesis Group, a sustainability consulting agency. The Activator is a group of Phoenix-area organizations interested in shaping the ET landscape to positively influence the well-being of Arizonans. With this in mind, they have asked our team to focus on making the transition to electric transportation equitable and inclusive. Our report details the current state of electric transportation nationally and locally, analyzes equitable EV/ET programs and utility plans across the country, and reviews the City of Tempe’s electric transportation related efforts. For this, we conducted listening sessions with a national expert, the City of Tempe, Tempe Community Action Agency, and CHISPA, creating a Community Listening Pilot Project based on the preliminary listening sessions. Through our research, listening, and discussions we compiled tiered recommendations for the TE Activator that suggest systemic policy changes based on community priorities. Accompanying the report is an Equity Roadmap, Community Listening Script, and one-page Debrief.
ContributorsBartholomew, Anna (Author) / Fielding, Raven (Author) / Logan, Grace (Author) / Shufeldt, Kaleigh (Author) / Stivers, John (Author)
Created2022-04