Programs and Communities
The collection collates collections by schools, centers, programs, and research groups.
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- All Subjects: Diabetes Mellitus
- All Subjects: Preventive Health Services
- Creators: Arizona State University. College of Nursing & Healthcare Innovation
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 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
Description
Medicare implemented a yearly Annual Wellness Visit (AWV) to improve quality patient care through early detection of declining health. However, there has been only partial provider participation since its inception, which potentially delays treatment and negatively impacts patient outcomes. The aim of this quality improvement project was to assess the feasibility of implementing a standardized electronic AWV template into private primary care practices to improve the consistency of delivery and documentation. The project designer utilized the theory of transitions (TOT) to facilitate the project execution. An electronic Excel-based template was designed to capture and calculate all aspects of the AWV, including billing codes, to allow for ease and consistency of use within a small primary care practice over two weeks. A provider performed the AWVs using the electronic template after completing a hands-on tutorial and reviewing an educational handout. Data were retrieved from a 7-question, 5-point Likert scale questionnaire given to the provider to assess the effectiveness of the electronic template versus a paper assessment. The results of this study indicated overall satisfaction with using leveraged technology to provide consistency of AWVs to improve patient outcomes, provider satisfaction, and increase revenue through uniform charting and billing. The outcomes of this project provide a basis of existing evidence for using standardized methods to perform and track Medicare AWVs.
ContributorsHill, L. Michelle (Author) / Rauton, Monica (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
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 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
Description
Background: Type II diabetes mellitus (T2DM) is a growing issue globally. Social determinants of health (SDH) play a crucial role on patients’ outcomes and complications from the disease. Hispanics are twice as likely to suffer from T2DM when compared to non-Hispanic whites, and they often rely on federally qualified community health centers (FQCHC) for their medical needs. These centers are then faced with high volume of patients with high acuity, which leads to limited time and resources to provide diabetic education.
Methods: The Purnell model of cultural competence will be used as a framework to provide unbiased, culturally tailored (CT) education to improve patients’ outcomes. The advancing research and clinical practice through close collaboration (ARCC) model will be used as it focuses on evidence-based practice (EPB) implementation that is sustainable across the system.
Purpose: The purpose of this EBP project is to promote culturally tailored (CT) DSME at a low-income FQCHC in greater Phoenix to improve diabetes outcomes and decrease complications from the disease. Consequently, decreasing the costly effects of diabetes complications to patients, FQCHC, and the state of Arizona.
Conclusion: Evidence suggest that diabetes self-care management education (DSME) is successful, independent of the format of delivery, in improving diabetes outcomes and patients’ self-care. However, it is underutilized in the United States even though it is a covered Medicare service.
ContributorsDavis, Maria Regiane (Author) / Rauton, Monica (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28