Programs and Communities

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.

The purpose of this project was to evaluate the State Bar of New Mexico's (SBNM) new podcast series, SBNM is Hear. The podcast was initially developed as a member outreach tool and a new platform for professional development and survey questions were developed to gauge the podcast’s effectiveness in these two areas. An electronic survey was deployed to active members of the SBNM through email. Respondents were asked questions regarding their demographics, whether they had listened to the series, and what content they would like to hear in the future. The survey resulted in 103 responses, of which 60% indicated that they had not listened to the podcast. The results showed that listenership was evenly divided between generations and that more females listened to at least one episode. The open-ended responses indicated that the two cohorts of respondents (listeners and non- listeners) viewed the podcast a potential connection to the New Mexico judiciary. Future recommendations include conducting an annual survey to continue to understand the effectiveness of the podcast and solicit feedback for continued growth and improvement

This applied project investigates the methods, modes, and tools used to communicate between different audiences at Divine Unity Community Church (DUCC) to create a communication guide. Communication is an integral part of the church’s function and effectiveness, not only externally to the congregation and surrounding community, but also internally to ministers, leaders, and volunteers. As the church continues to grow, it has struggled to maintain a consistent, efficient, and scalable communication culture. To document and sustain the communication culture, I drafted a communication guide that provides a comprehensive explanation of the church’s culture and tools for communicating in different contexts. The guide was developed with feedback from focus groups and observations of DUCC’s communication practices, and is being used as a training resource for leaders and volunteers.

As the impact of technology on daily life continues to grow, online learning platforms for primary, secondary, post-secondary, and professional institutions find ways to:

1. Connect peers and instructors through digital communication.
2. Engage users more fully in learning.
3. Provide access to resources that enhance deep-impact education.

Online learning platforms, or learning management systems (LMS), are used to connect instructors and students through synchronous and asynchronous engagement tools, provide space for the transfer of resources and ideas, and track progress. However, these platforms were designed with more mainstream purposes - and more digitally savvy - users in mind.

Adult learning programs (with members ages 50+) currently have no online learning and sharing platform specifically designed to fit the needs and desires of their users. Despite the multitude of barriers to successful use, adult learning programs recognize the need to engage with members digitally and are seeking an online learning platform centered around their users.

This project, utilizing best practices in technical communication and mixed methods user experience research, broadens the boundaries of communication design by creating an online learning platform prototype specifically for adults ages 50+ through the lens of information design, content management, and user experience outcomes.

This report aims to provide The Arts Partnership, an arts-based non-profit organization in the Fargo, ND-Moorhead, MN area, with recommendations on improving its “Connecting the Dots” weekly e-newsletter. The research was conducted using three separate channels – a quantitative survey of the current e-newsletter recipients, a qualitative coding exercise to uncover themes in each e-newsletter, and an analysis of the top-clicked links in each e-newsletter. The original research, combined with information gleaned from the literature review, results in seven recommendations The Arts Partnership can implement into its current program. These recommendations include reducing the amount of HTML in each e-newsletter to avoid SPAM traps, keeping the email as scannable as possible, maintaining its subscriber base to eliminate waste, ensuring its e-newsletters are mobile-responsive, improving the subject line of the e-newsletters, and finally, considering using a different email program that provides more features The Arts Partnership can use to continue to improve its newsletters.

In this case study, the formal feedback process of the PCC was researched to determine if the process causes a potential threat state within PCC representatives, and, if so, identify aspects of the process that are potential causes of the threat state. Researched was complete via survey, and data was analyzed using open coding and various quantitative methods. Based on the data obtained in the survey, a threat state was determined to exist due to the feedback process, and two potential causes were identified. A recommendation report was built from the data, and two recommendations were presented. The first recommendation was to adjust to process of how feedback is sent to a PCC rep, and the second was around how often that feedback is delivered. Also included in the recommendation report was discussion around limitations to the research and how those are potential options for future research.

Operational materials--the procedural guidelines provided to front line employees of Banner Bank--act as a guide to completing complex banking transactions. Being able to successfully navigate these materials and complete the complex transactions are essential to meeting both the client's expectations and maintaining federal regulations. However, employees have noted a lack of usability with these materials, resulting in confusion and frustration while trying to navigate the operational materials to successfully complete client requests. Employees who try to use these guides commit errors that result in negative client impact, as well as putting the bank at risk for being out of compliance with federal regulations. To analyze and address this situation, I designed a usability test and deployed a survey given to division branch management.