Programs and Communities

Disease burden is higher in the United States than in comparable countries. The Patient Self Determination Act of 1990 requires healthcare facilities to provide Advance Care Planning (ACP) information to all Medicare patients. The healthcare staffs’ (n=7) commitment to 3-days of ACP training increase ACP rates in the primary care setting. The Medicare Incentive Program is the platform for this initiative. This quantitative project used a valid and reliable pre and posttest design that consisted of 27 items on a Likert-scale. A 3.5-month chart audit (n=91) was conducted to assess the completion rate. Descriptive statistics was used to describe the demographic data.

The results of the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -2.37, p = .018. There was a significant increase in the post-readiness to change average scores. A Mann Whitney test was used to analyze the statistically significant difference between the averages in two ACP types and electronic health record documentation (EHR). Staff did not always code (Mdn = 0.00) but they documented in the EHR (Mdn =1.00; 512.00, p = 0.003). ACP discussion was performed 63% of the time during Annual Wellness Visits (AWV), and there was a 49% increase in the EHR documentation. Trained staff are key stakeholders in guiding ACP conversations. They understand the barriers, impact, and consequences related to the lack of advance directives.

Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.

Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).

A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.

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.

Purpose: To collect and analyze participant demographic information and explore use of instruments to measure perceived social support and quality of life at a local cancer support program. Specific objectives included:

1. Gather and analyze participant demographic information and program utilization by participants for a non-profit cancer support agency.
2. Assess the extent to which those using the support programs experience perceived social support (PSS) and quality of life (QOL).
3. Assess the utility of the survey process and selected instruments to guide program planning.

Background: Obtaining the diagnosis of cancer is traumatic, but support groups assist in emotional healing among group members. There is strong evidence correlating support group participation with PSS and QOL. The Wilson and Cleary model of QOL clearly links social support and QOL and provided the conceptual framework for this project.

Methods: A survey for self-reported participant demographics, support activities, QOL scores, and PSS scores was implemented. Both online and pencil and paper surveys were available. Instruments included the Flanagan Quality of Life Scale (Cronbach’s α = .82 to .92) and the Multidimensional Scale of Perceived Social Support Scale (Cronbach’s α = 0.91) and a demographic survey created for this project.

Outcomes: All but one survey was completed online (n=48). Respondents were primarily white, female, cancer free at the time of the survey, and over the age of 55. QOL and PSS scores within this sample emulated previous research of correlations between instruments and people with chronic illnesses.

Conclusion: Correlations of sample demographics and instrument scores reflected current literature; this project validates an effective and affordable means to evaluate program effectiveness. Future use of the survey is to better tailor services to meet the objectives of the agency to improve QOL for all individuals affected by cancer.

Keywords: Cancer, support group, quality of life, perceived social support

Children with congenital heart disease (CHD) are at increased risk for psychosocial issues (PSI), decreased quality of life (QOL), and decreased resilience. The purpose of this project was to implement a screening protocol for PSI, QOL, and resilience, with appropriate psychosocial referral for children with CHD.

A pilot protocol was implemented to screen children with CHD, aged 8-17 years, and parents, for resilience, QOL, and PSI. Referrals for psychosocial services were made for 84.2% of children screened (n = 16) based on scoring outcomes. Statistically significant differences in the parents and children’s resilience mean scores were noted. Higher parental scores may indicate that parents believe their children are more resilient than the children perceive themselves to be.
Early identification of concerns regarding QOL, resilience, and PSI in children with CHD can provide ongoing surveillance, while affording opportunities for improved communication between providers, parents, and children. Routine screening and longitudinal follow-up is recommended.