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For decades, understanding the complexity of behaviors, motivations, and values has interested researchers across various disciplines. So much so that there are numerous terms, frameworks, theories, and studies devoted to understanding these complexities and how they interact and evolve into actions. However, little research has examined how employee behaviors translate

For decades, understanding the complexity of behaviors, motivations, and values has interested researchers across various disciplines. So much so that there are numerous terms, frameworks, theories, and studies devoted to understanding these complexities and how they interact and evolve into actions. However, little research has examined how employee behaviors translate into the work environment, particularly regarding perceived organizational success. This study advances research by quantitatively assessing how a greater number of individual employees’ pro-environmental behaviors are related to the perceived success of environmentally sustainable workplace activities. We have concluded that the more pro-environmental behaviors an employee embodies, the more positively they perceive the success of their local government's sustainable purchasing policy. Additionally, other factors matter, including organizational behaviors, like training, innovation, and reduction of red tape.

ContributorsFox, Angela (Author) / Darnall, Nicole (Thesis advisor) / Bretschneider, Stuart (Committee member) / Behravesh, Shirley-Ann (Committee member) / School of Sustainability (Contributor)
Created2022-04-19
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BACKGROUND: The City of Phoenix initiated the HeatReady program in 2018 to prepare for extreme heat, as there was no official tool, framework, or mechanism at the city level to manage extreme heat. The current landscape of heat safety culture in schools, which are critical community hubs, has received less

BACKGROUND: The City of Phoenix initiated the HeatReady program in 2018 to prepare for extreme heat, as there was no official tool, framework, or mechanism at the city level to manage extreme heat. The current landscape of heat safety culture in schools, which are critical community hubs, has received less illumination. HeatReady Schools—a critical component of a HeatReady City—are those that are increasingly able to identify, prepare for, mitigate, track, and respond to the negative impacts of schoolgrounds heat. However, minimal attention has been given to formalize heat preparedness in schools to mitigate high temperatures and health concerns in schoolchildren, a heat-vulnerable population. This study set out to understand heat perceptions, (re)actions, and recommendations of key stakeholders and to identify critical themes around heat readiness. METHODS: An exploratory sequential mixed-methods case study approach was used. These methods focused on acquiring new insight on heat perceptions at elementary schools through semi-structured interviews using thematic analysis and the Delphi panel. Participants included public health professionals and school community members at two elementary schools—one public charter, one public—in South Phoenix, Arizona, a region that has been burdened historically with inequitable distribution of heat resources due to environmental racism and injustices. RESULTS: Findings demonstrated that 1) current heat safety resources are available but not fully utilized within the school sites, 2) expert opinions support that extreme heat readiness plans must account for site-specific needs, particularly education as a first step, and 3) students are negatively impacted by the effects of extreme heat, whether direct or indirect, both inside and outside the classroom. CONCLUSIONS: From key informant interviews and a Delphi panel, a list of 30 final recommendations were developed as important actions to be taken to become “HeatReady.” Future work will apply these recommendations in a HeatReady School Growth Tool that schools can tailor be to their individual needs to improve heat safety and protection measures at schools.

ContributorsShortridge, Adora (Author) / Walker, William VI (Author) / White, Dave (Committee member) / Guardaro, Melissa (Committee member) / Hondula, David M. (Committee member) / Vanos, Jennifer (Committee member) / School of Sustainability (Contributor)
Created2022-04-18
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Background: Workplace violence (WV) is a significant problem in healthcare that affects the nurses' physical and mental health and impacts patient care. This is costing healthcare organizations millions of dollars for damage control as there is a lack of prevention. Hence, this evidence-based practice project uses the theory of planned

Background: Workplace violence (WV) is a significant problem in healthcare that affects the nurses' physical and mental health and impacts patient care. This is costing healthcare organizations millions of dollars for damage control as there is a lack of prevention. Hence, this evidence-based practice project uses the theory of planned behavior and nursing process discipline theory to explore the effectiveness of screening patients for violence. Method: After an aggregate IRB approval, a violence screening tool with high sensitivity and specificity, Broset Violence Checklist (BVC), was implemented twice daily and as needed for 15 days with 275 adult patients in a neurology/telemetry unit to help identify patients at high-risk for violence. All interventions and procedures were based on established policies, not the BVC score. Results: A generalized estimating approach with a logit link and linear regression was used for data analysis. Of the 1504 BVC screenings completed, 43 violent incidents were reported, with interventions recorded in 106 (7.1%) screenings. Patients with a BVC score of <2 required an intervention 16 times (1.2%), and BVC score of >2 required an intervention 90 times (54.2%), OR= 17.95 (95% CI: 3.55 to 90.84), p< 0.001. Discussions: Total BVC score, male gender, and older age were highly predictive of violence. Also, as the BVC score increased above 1, additional interventions were utilized. Conclusion: The BVC has value, indicating that patients who score above 1 can pose enough threat to require an intervention. Thus, uncovering risks and identifying the potential for violence is essential to diminishing harm and WV.
ContributorsSilwal, Sadikshya (Author) / Moffett, Carol (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-01
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According to The Joint Commission, most sentinel events in healthcare can be attributed to errors in communication. Thousands of medical students in the United States lack adequate communication training. Current literature illustrated that communication skills training programs increase confidence and communication skills of medical students and residents. These programs vary

According to The Joint Commission, most sentinel events in healthcare can be attributed to errors in communication. Thousands of medical students in the United States lack adequate communication training. Current literature illustrated that communication skills training programs increase confidence and communication skills of medical students and residents. These programs vary in techniques, with many including lectures and role play exercises. This project aimed to improve outcomes at a forensic facility in Arizona by utilizing a student role play intervention and lecture. Outcomes were measured utilizing developed pre- and post-intervention surveys. The surveys included a validated tool which measured four communication skill categories. A convenience sample consisted of pre-medical interns who participated in the project. The small sample size (four) led to descriptive statistics utilization to provide preliminary data. Prior to the intervention, communication skill average scores were as follows: listening (15), giving and getting feedback (12), sending clear messages (13.75), and handling emotional interactions (11.5). Post-intervention, the average scores for the communication skills were as follows: listening (18.25), giving and getting feedback (13), sending clear messages (16), and handling emotional interactions (12.75). Average scores for each category showed an increase after the implementation of the intervention. The survey was completed for four (100%) of participants, and 75 percent of participants stated they felt more confident with utilizing communication skills in their internship. A communication skills training program can enhance communication skills of medical trainees by providing structured support. Further research is needed on effective techniques to train medical trainees.
ContributorsIliescu, Michelle (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
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Background: Obesity is a known comorbidity for chronic disease and is responsible for 47% of related medical costs. Recognizing the complex etiology of obesity, the need for an effective and comprehensive screening tool will assist primary care providers in assessing their patient's needs and facilitating success in managing their weight

Background: Obesity is a known comorbidity for chronic disease and is responsible for 47% of related medical costs. Recognizing the complex etiology of obesity, the need for an effective and comprehensive screening tool will assist primary care providers in assessing their patient's needs and facilitating success in managing their weight and health. Primary care providers (PCP) have limited knowledge of current evidence in obesity treatment. The project guides the form of tools to help identify the patients' self-efficacy, change readiness, and insurance reimbursement. Methods: Expedited IRB approval was obtained, allowing for data analysis from completed de-identified screenings, surveys, and medical records gathered between September 2022 and April 2023. Screenings including Weight Efficacy, Lifestyle long-form (WEL-LF), and Stages Of Change Readiness And Treatment Eagerness Scale In Overweight And Obesity (SOCRATES-OO) were used to assess the effectiveness of the treatment plan. Russwurm and Larrabee's model for evidence-based practice change was chosen for the project's framework. The provider was given a guide for obesity management with tips for billing insurance. A convenience sample of eight patients met with the providers over three months as part of their obesity management treatment plan. Results: The pre and post-screenings collected from the remaining participants (n=8) showed no statistical differences. However, the satisfaction and feedback survey from patients (n=8), provider (n=1), and office staff (n=4) showed improved quality of care and greater confidence in the provider's part in initiating and managing their patient's chronic obesity. Conclusion: Improving PCPs' knowledge of Obesity treatment improves patient care. Expanding this project to a larger scale and disseminating the information can impact patients' lives positively. Keywords: Obesity; self-efficacy; readiness for change; stages of change; primary care, Weight Efficacy Lifestyle questionnaires
ContributorsBrock-Andersen, Marian (Author) / Moffett, Carol (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-28
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Nonadherence to psychiatric medications was identified as an issue worldwide and in a non-profit organization for women recovering from substance use disorders (SUD) in the southwestern United States. Non-adherence is associated with increased hospitalizations and relapse. A literature review indicated that motivational interviewing (MI) was an evidence-based intervention for increasing

Nonadherence to psychiatric medications was identified as an issue worldwide and in a non-profit organization for women recovering from substance use disorders (SUD) in the southwestern United States. Non-adherence is associated with increased hospitalizations and relapse. A literature review indicated that motivational interviewing (MI) was an evidence-based intervention for increasing psychiatric medication adherence in women recovering from SUD. This project aimed to assess if training the organization staff on MI, would impact their beliefs, knowledge, and comfort of using MI on their clients with non-adherence. The Theory of Planned Behavior is the underlying principle of the project. A recruitment flyer was sent to the organization via email, and interested staff attended the training on the basics of MI via a PowerPoint presentation through video conferencing. Pre-, post-, and one-month follow-up questionnaires were provided to assess participants' knowledge, familiarity, and comfort with MI. The questionnaires consisted of the reliable/validated Beliefs About Medication questionnaire (BMQ) and questions about MI. Participants were deidentified for data collection. A Friedman's test and descriptive statistics were used for analysis. 17 staff participated; five one-month follow-ups were completed. Participants believed medication was more beneficial than harmful and necessary for improvement-nonsignificant: Friedman test p = .179. Upon follow-up, 40% reported being comfortable using MI while 60% reported they had not used MI yet. MI training may improve staff comfort and ability to address medication nonadherence. A larger sample may lead to significant and generalizable results.
ContributorsDarko-Amoako, Princess (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-28
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Loneliness and depression in older adults are under-recognized public health concerns that increase risks for all-cause mortality, medical morbidity, and rising healthcare costs. This quality improvement project assessed whether smartphone Mindfulness software mitigated self-reported feelings of loneliness and depression among community-dwelling older adults. Nine participants aged 65 and older, living

Loneliness and depression in older adults are under-recognized public health concerns that increase risks for all-cause mortality, medical morbidity, and rising healthcare costs. This quality improvement project assessed whether smartphone Mindfulness software mitigated self-reported feelings of loneliness and depression among community-dwelling older adults. Nine participants aged 65 and older, living at home, experiencing loneliness or depression, and owning a smartphone were recruited using newsletters and fliers. A short demographics questionnaire and two valid and reliable instruments, namely the University of California Los Angeles Loneliness Scale (UCLA V3) and Geriatric Depression Scale (GDS), were used in pre-intervention and four weeks post-intervention. Participants downloaded the UCLA Mindful app on their smartphones after attending a 20-minute Mindfulness education at a local church banquet room. Participants used the UCLA Mindful software twice weekly for ten minutes for four weeks. Of the nine participants, three completed the study. A two-tailed paired sample t-test and descriptive analysis were used to evaluate the efficacy of the UCLA Mindful smartphone software. The results of the two-tailed paired sample t-test were not statistically significant for the UCLA V3 Loneliness scale (p=.220) and GDS (p=.208) due to the small sample size. Although the results were negligible, participants nevertheless reported favorable impacts. Future research with a larger sample size is encouraged.
ContributorsMurdock, J. Kristine (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
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An alarming number of youth have mental health concerns, but of those who are diagnosed, only half receive treatment. Using Bandera's social cognitive theory, one can achieve behavioral changes through self-efficacy and control their actions by self-regulation. Mindfulness activities, when implemented early, can decrease stress, and improve well-being in youth.

An alarming number of youth have mental health concerns, but of those who are diagnosed, only half receive treatment. Using Bandera's social cognitive theory, one can achieve behavioral changes through self-efficacy and control their actions by self-regulation. Mindfulness activities, when implemented early, can decrease stress, and improve well-being in youth. Methods: This project was implemented among students attending an alternative high school in Arizona. Nine students participated in four different mindfulness, hands-on activities during two classes- 1 hour each. Participants completed a pre and a post-test with the 10-item questionnaire Perceived Stress Scale (PSS), and a 3-question survey to evaluate the program at the end of the second week. Results: Among the 9 participants (mean age = 16 SD=2.06), the stress levels were considered low to moderate in the pretest (mean=16.56) and the post-test (mean=15.89). Stress level scores were reduced after the education although the difference was not statistically significant. Furthermore, all participants agreed that the content and activities were appropriate, 88.9% agreed they had a "better understanding of how to reduce stress," and 77.8% stated their "knowledge of stress has improved." Discussion/Conclusion: This project aimed to help reduce vulnerable adolescents' stress level through mindfulness activities. Mental health education like this may help adolescents better manage stress and consequently promote their overall well-being. Future projects should recruit a larger sample and implement a longer time for larger and longer effects.
ContributorsQualman, Stephanie (Author) / Chen, Angela (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-10
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Mental health challenges are becoming a significant public health issue for adolescents/teenagers, and primary interventions have been focused on mental health education. Because adolescents spend most of their time in school, primary mental health interventions should be prioritized in this setting. A PICOT question was developed to determine if mental

Mental health challenges are becoming a significant public health issue for adolescents/teenagers, and primary interventions have been focused on mental health education. Because adolescents spend most of their time in school, primary mental health interventions should be prioritized in this setting. A PICOT question was developed to determine if mental health literacy (MHL) in adolescents would improve while decreasing stigma and improving help-seeking behaviors after a program of enhanced mental health education. Partnering with a large Arizona suburban school district social work department, a teen Mental Health First Aid (tMHFA) pilot program was implemented for a class of nine (n = 9) adolescent students (aged 17-18 years) old during the school day. tMHFA was delivered in three 90-minute class days. Using the Mental Health Literacy questionnaire (MHLq), a pre and post-test design revealed a significant (p value=less than 0.05) increase in the students' MHL, help-seeking behaviors, and decreased stigma after delivery. This quality improvement project was IRB approved, and all human subjects' rights were protected. In conclusion, there is strong evidence that enhanced mental health programming, such as tMHFA, effectively educates adolescents about mental health challenges and, perhaps, could promote behavioral changes in future generations.
ContributorsJones, M. Christina (Author) / Schiller, Zita (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-15
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Substance use disorder has been increasing in the United States year after year. Modern treatments fail as often as they succeed. The current standards of practice fail to provide patients with the ability to harness thoughts and control anxiety. Mindfulness practices are currently being adapted as a therapeutic technique to

Substance use disorder has been increasing in the United States year after year. Modern treatments fail as often as they succeed. The current standards of practice fail to provide patients with the ability to harness thoughts and control anxiety. Mindfulness practices are currently being adapted as a therapeutic technique to address some of these concerns. An exhaustive literature review was conducted to investigate how various mindfulness techniques impact substance use disorder. Ten high-quality studies were retained and synthesized to show current understandings of the effectiveness of a mindfulness therapeutic technique. An evidence-based intervention is suggested for implementing mindfulness-based relapse prevention into a residential treatment facility. The intervention created incorporates the self-efficacy theory and an adapted health-belief model. Adults in a residential treatment facility for substance use disorder were given eight mindfulness sessions over the course of four weeks. Participants were given pre- and post-intervention screenings for mindful attention and anxiety. The data analysis after two-tailed paired T-tests showed that anxiety significantly decreased (α=.05, p<.001) and mindful attention increased significantly (α=.05, p=.015). Overall, mindfulness shows promise in its potential to reduce substance abuse.
ContributorsWandler, Ryan (Author) / Nunez, Diane (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27