The Doctor of Nursing Practice Final Projects collection contains the completed works of students from the DNP Program at Arizona State University's College of Nursing and Health Innovation. These projects are the culminating product of the curricula and demonstrate clinical scholarship.

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Adolescents in the U.S. are experiencing a growing epidemic of maladaptive coping. The increasing occurrence of these behaviors make it likely that school personnel will continue to see an increase in adolescents presenting with maladaptive coping patterns, such as nonsuicidal self-injury and suicide, highlighting the urgency for continued research regarding

Adolescents in the U.S. are experiencing a growing epidemic of maladaptive coping. The increasing occurrence of these behaviors make it likely that school personnel will continue to see an increase in adolescents presenting with maladaptive coping patterns, such as nonsuicidal self-injury and suicide, highlighting the urgency for continued research regarding effective education. Nonsuicidal self-injury is highly correlated with suicidal behavior, and suicide is the second leading cause of death among ten to nineteen year olds in the US. Research points to the use of a specific type of Coping Skills Training known as Mental Health Literacy that reduces the chances that maladaptive coping will become the norm in adulthood.
ContributorsLandon, Rebecca J. (Author) / McIntosh, Wayne (Thesis advisor)
Created2019-04-15
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Description
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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Description
Introduction: Poor knowledge and negative perceptions regarding mental health disorders are barriers to parents seeking mental health care for their child. Mental health literacy comprises both the knowledge and ability to recognize mental health disorders, combat stigma, and obtain treatment. Research demonstrates increased mental health literacy increases parental help-seeking behaviors.

Introduction: Poor knowledge and negative perceptions regarding mental health disorders are barriers to parents seeking mental health care for their child. Mental health literacy comprises both the knowledge and ability to recognize mental health disorders, combat stigma, and obtain treatment. Research demonstrates increased mental health literacy increases parental help-seeking behaviors. Aim: To increase mental health literacy of parents in Maricopa County through increased access to evidence-based education and support. Methods: A local mental health organization utilized the Model for Improvement (MFI) Plan Do Study Act (PDSA) quality improvement framework to increase the number of parents attending an evidence-based, six-session educational class and bi-monthly support group. Interventions included 1) outreach and recruitment via social media and community partners, and 2) convening one six-week educational class and four support group sessions. Results: Parental awareness and attitudes toward mental health disorders were measured at Class One (N=11, M = 30.9, SD 5.15) and Class Six (N=5, M = 40.2, SD 1.64) and analyzed utilizing the Mann-Whitney U Test; results demonstrate improved awareness and attitudes (U =50, p = .001). Eleven parents attended a support group session; 91% (10) reported they learned new information about how to support their child; 82% (9) reported they improved their ability to access and advocate for mental health services. Conclusions: Findings suggest that participating in this organization’s educational classes and support groups increases mental health literacy. Barriers that prevent more parents from participating should be explored.
Created2021-04-27
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Description
Objective: Mental health illnesses are complex conditions that afflict many university students. International students are uniquely vulnerable to these conditions due to challenges such as adjusting to the new environment and culture of American universities. They are also less likely than domestic students to receive mental health services. Research indicates

Objective: Mental health illnesses are complex conditions that afflict many university students. International students are uniquely vulnerable to these conditions due to challenges such as adjusting to the new environment and culture of American universities. They are also less likely than domestic students to receive mental health services. Research indicates that there are obstacles for international students when it comes to seeking mental health services, but these obstacles are typically over-generalized and less applicable to each specific university setting. The purpose of this paper was to assess the barriers in seeking mental health services by international students. Participants: International students at a large university located in Southwestern United States. Students 18 years of age or older, enrolled as an international student, proficient in English, exhibiting mental health symptoms, and refusal of primary care physician’s referral to mental health services. Method: Physicians at Health Services verbally recruited the participants during routine visits. Participants did not provide any personal information, and completion of the questionnaire indicated their consent. This project was guided by the model of mental health help-seeking, where a questionnaire was administered to students, allowing them to identify what specifically prevents them from receiving mental health services. Result: Due to the COVID-19 pandemic, only 1 questionnaire was completed, but it was rejected as it was filled by domestic student. Conclusion: The data gathered through this questionnaire was intended to be provided to university healthcare providers to better understand how they can connect with international students with mental health concerns.
Created2021-04-27
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Description
Childhood cancer affects nearly eleven-thousand children under the age of fifteen years each year, which launches families into a treatment trajectory of unforeseen complexities in several domains. As pediatric oncology healthcare providers tailor family-centered care for these highly fragile children, it is vital to understand the family’s lifestyle and available

Childhood cancer affects nearly eleven-thousand children under the age of fifteen years each year, which launches families into a treatment trajectory of unforeseen complexities in several domains. As pediatric oncology healthcare providers tailor family-centered care for these highly fragile children, it is vital to understand the family’s lifestyle and available community resources. Children residing in remote areas may experience more burdensome needs as they progress in the cancer treatment trajectory, which healthcare providers may not be aware of unless the information is specifically solicited or incidentally discovered. Use of an evidence-based needs assessment for families who reside in remote zip codes will aid in identification of unique needs and assist the multi-disciplinary care team to specifically tailor interventions to the family. Forty semi-structured interviews were conducted with parents of childhood cancer survivors using an expert-validated needs assessment tool. The purpose of this Doctor of Nursing Practice (DNP) project is to develop a needs assessment for children with cancer in order to identify which needs are amplified in a remote community in order to match and create resources to meet those needs.
Created2021-04-30
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Description
Primary health care clinics are essential first defenders determined to confront the upsurge in health-related leading causes of death in the United States. Unfortunately, the underserved or uninsured community continues to struggle to access these vital health care services. Consequently, this vulnerable population seeks venues such as community services events

Primary health care clinics are essential first defenders determined to confront the upsurge in health-related leading causes of death in the United States. Unfortunately, the underserved or uninsured community continues to struggle to access these vital health care services. Consequently, this vulnerable population seeks venues such as community services events to obtain these unmet primary care services. Community services events effectively disseminate health-related material and provide access to vital medical services. Currently, community services strive to bridge the gap between underserved individuals and primary care clinics by providing participants referrals for low-fee or free clinics to establish ongoing care. A lack of data exists on whether these events sufficiently impact the participants to motivate them to follow-up with a health care clinic. A critical appraisal of evidence showed that follow-up adherence rates are remarkably improved by directly referring participants to a primary clinic during a community services event. This paper explores the effect on health outcomes and health disparities when establishing connections between community services participants and ongoing healthcare services.
Created2021-04-22
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Description
Purpose: The purpose of health literacy education is to increase an individual’s understanding of health and use of the healthcare system. Low health literacy is associated with misuse of healthcare resources and misunderstanding of healthcare teaching. Education has demonstrated efficacy in improving health literacy. A personalized educational program was provided

Purpose: The purpose of health literacy education is to increase an individual’s understanding of health and use of the healthcare system. Low health literacy is associated with misuse of healthcare resources and misunderstanding of healthcare teaching. Education has demonstrated efficacy in improving health literacy. A personalized educational program was provided to parents of Head Start children, offered in Spanish and English, and at a 3rd to 5th education level.

Design: Using an established program for health literacy education, a Doctor of Nursing Practice project was implemented. The effect the program had on increasing the health literacy of participants over a period of 4 weeks was examined. The predominately, Latina participants received three hours of instruction based upon the health literacy book “What to do When Your Child Gets Sick”.

Setting and Subjects: The educational program took place in a large, urban county in the Southwestern United States with 24 parents of preschool age children in Head Start.

Intervention: The educational program contained three hours of classroom instruction utilizing PowerPoint® presentation, demonstration, and teach-back techniques on how to care for a child’s healthcare needs.

Measures and Analysis: Pre-, post- and telephone surveys were used to assess the impact of the health literacy educational program. Wilcoxon and Freidman tests were used to interpret the results.

Results: Despite no significant increases in health literacy post implementation, participants’ remarked that they felt the class was helpful and wanted to share the information with friends and family. They appreciated the program and wanted more educational opportunities.

Conclusion: Advanced practice nurses must acquire understanding, cultural sensitivity, and assess the needs of the community when implementing health literacy educational projects.
ContributorsVasquez, Damara (Author) / Jacobson, Diana (Thesis advisor)
Created2017-05-02
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Description

As the incidence of acute and chronic wound conditions rises and wound dressing protocols become more complex, uninsured patients lacking access to specialty wound care are challenged to manage their own wounds. Understanding multistep dressing change protocols may be inhibited by low health literacy. Low health literacy is associated with

As the incidence of acute and chronic wound conditions rises and wound dressing protocols become more complex, uninsured patients lacking access to specialty wound care are challenged to manage their own wounds. Understanding multistep dressing change protocols may be inhibited by low health literacy. Low health literacy is associated with reduced disease knowledge and self-care. Little evidence of health literacy effects on wound patients is available nor are literacy-sensitive educational interventions that address wound knowledge and self-care. Improved outcomes occur in all health literacy levels in other diseases with the use of literacy-sensitive educational interventions that incorporate more than one literacy strategy over multiple sessions. To examine the effectiveness of a literacy-sensitive wound education intervention on wound knowledge and self-care, an evidence-based pilot project was conducted in an urban wound clinic.

A convenience sample of 21 patients received a literacy-sensitive wound education intervention consisting of spoken and written communication over several sessions. Instruments measured health literacy level, wound knowledge, dressing performance, and wound healing status. There was a significant increase in wound knowledge scores in all literacy groups from baseline to visit two (p < .01) and four (p < .01). Dressing performance scores remained consistently high through visit four in all literacy levels. All participant’s wounds progressed toward wound healing significantly from baseline to visit two (p < .01) and four (p < .01). Incorporation of a literacy-sensitive education intervention with supportive literacy aids over several sessions supports improved wound knowledge and dressing self-care and can affect healing in patients of all health literacy levels.

ContributorsTharalson, Erin (Author) / Root, Lynda (Thesis advisor)
Created2018-04-20
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Description
Background: Only 40%-80% of health information is retained during an office visit due to ineffective communication. Caregivers, and patients, are unable to remember how to manage their health care needs. Teach back is an effective tool that encourages a conversation between the caregiver/patient and provider. The purpose of this project

Background: Only 40%-80% of health information is retained during an office visit due to ineffective communication. Caregivers, and patients, are unable to remember how to manage their health care needs. Teach back is an effective tool that encourages a conversation between the caregiver/patient and provider. The purpose of this project is to increase knowledge retention and self-management behaviors using a headache teach back tool.

Methods: The quality department at a large children’s hospital in the southwestern United States approved the project as a practice change and parent consent was not required. The project design was a randomized controlled group: pretest-posttest design, quality improvement method. Participants were chosen by convenience sample. Required diagnoses were headache or migraine. Each group had 18 participants, for a total of 36 participants. Ages ranged from four to 18 years of age, with legal guardians present for the intervention group only. New and follow-up patients were included in the project. Demographics for each group were statistically similar. Questionnaires were used to assess knowledge pre and post implementation of teach back tool. Self-management was measured by a follow-up phone call after their appointment to inquire regarding implementation of the headache diary. Charts were reviewed for both groups regarding the number and type of phone calls received by the office.

Outcomes: Paired sample t-test was used to evaluate mean differences in knowledge from pre and post questions of teach back tool. Data analysis concluded a statistical increase in knowledge of triggers and prevention techniques. Cohen’s d for triggers was 2.21 and 1.87 for prevention. Self-management of behavior was measured by use of headache diary and determined by a percentage. Sixty-seven individuals started to use the headache diary. Independent t-test was used to compare number of phone calls from each group. Data concluded a decrease in phone calls. However, due to a small sample size, statistical significance could not be established.

Conclusion: Teach back encourages caregiver/patient and provider interaction, which increases health literacy retention and increases self-management behaviors. Future research should focus on patients with headaches with unknown triggers for their headaches.
ContributorsTwo, Melissa A. (Author) / Sebbens,, Danielle (Thesis advisor)
Created2019-05-01