Programs and Communities

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.

Maria is a United States citizen whose parents just recently obtained legal status in the US due to Maria having turned 21. Maria has been around the undocumented population her entire life due to a large part of her family being undocumented. She became very involved with the undocumented movement back in 2010 with the passing of SB1070 in Arizona. She states that the reason she became so involved at this time was because she realized how these anti-immigrant laws were affecting her family and her community. She has worked on many campaigns at the local level such as the recall of Russell Pierce, the Adios Arpaio Campaign among other things. She is set to graduate from ASU this May 2015 with a degree in Political Science and Transborder Studies, and hopes to study law one day. She currently works with Unite Here a labor union and continues to be involved with varies campaigns some being DACA/DAPA information sessions among other things

In her interview, Monica discusses her association with the Grassroots Leadership Organization and her involvement with DreamZone. She talks about why DreamZone is important and why she is politically inclined. She talks about DreamZone’s Clinton Global Initiative campaign and her involvement at the White House breakout sessions after DACA was signed. She has been involved in sit-ins and letter writing campaigns

Jonathan was born in a small farming town in Maryland. He talks about racism, segregation and the homophobic climate that prevailed in his hometown, and how that informed his activism and that of his parents. During middle school, he got involved in activism around queer youth of color. In the beginning, he was mostly involved in LGBT issues. Later, he also organized around economic injustice in peasant and working class communities.

Dulce attended school in Mexico up until junior high before coming to the United States on a visa. While in high school she became involved with the robotics team at Carl Hayden and thanks to the encouragement by her two teacher she decided to pursue a STEM education at ASU. She was enrolled at ASU already when the law passed and was unaware of any other undocumented student at the ASU campus at the time. It was through the scholarship(s) that were made available to these undocumented student who were already enrolled at ASU that these undocumented students connected. What originally started off as students discussing various topics through blackboard, then google drive, led to the founding of the Arizona Dream Act Coalition (ADAC). She is co-founder for the ADAC and was the acting president for 2 years, now she just volunteers whenever she can, currently running for a position in the upcoming Executive board. She graduated from ASU with a degree in mechanical engineering, but is currently has her own business as a real estate agent for the past 10 years. She is in the process of applying for citizenship.

In his interview, Seth discusses his hometown as well as his study abroad experiences. He describes how he has come to learn about the undocumented youth movement and his role in the DreamZone workshop. He talks about current political reform and his involvement in political discussion in person and on social media. He describes his experience with AZ Quip and how he feels it is included.

Jesus went to Gadsden High School in Anthony, New Mexico. He studied engineering at Texas A&M University, but ended up changing his major to journalism and mass communication with an emphasis in pubic relations. He worked in housing residential education for about a year in Florida, but later moved to Arizona State University to pursue a PHD in education policy and evaluation. Through his work with students and the community, he became aware of the political and social issues in Arizona. This awareness eventually led him and a friend to create DREAMzone.

Jesus is involved with DREAMzone, the Queer Undocumented Immigrant Project (Q.U.I.P.), Arcoíris Liberation Team, and Familia: Trans Queer Liberation Movement (California). He was president of the Latino Graduate Student Alliance and is currently the vice-president of the Graduate & Professional Student Association.

RESEARCH QUESTION: Does Online "Working Out Work" as a Treatment and Prevention for Depression in Older Adults? An Analysis of a Prescribed and Monitored Exercise Program Administered via the Internet for Senior Adults with Depression.
OBJECTIVE: The purpose of this study is to investigate and access the effectiveness of an online prescribed and monitored exercise program for the treatment of depression in Older Adults. The Dependent Variable for the study is Depression. The Independent Variable for the study is the Effects of Exercise administered via the Internet and the population is geriatric adults defined as senior adults aged 50 and older. Depression is defined by Princeton University Scholars (Wordnet, 2006) as a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity.
METHODS: The presence and severity of depression will be assessed by using The Merck Manual of Geriatrics (GDS-15) Geriatric Depression Scale. Assessments will be performed at baseline, before and after the treatment is concluded. The subjects will complete the Physical Activity Readiness Questionnaire (PAR-Q) prior to participating in an exercise program three times per week.
LIMITATIONS OF RESEARCH: The limitations of this study are: 1) There is a small sample size limited to Senior Adults aged 50 - 80, and 2) there is no control group with structured activity or placebo, therefore researcher is unable to evaluate if the marked improvement was due to a non-specific therapeutic effect associated with taking part in a social activity (group online exercise program). Further research could compare and analyze the positive effects of a muscular strength training exercise program verses a cardiovascular training exercise program.