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Description
Previous research has found improvements in motor and cognitive measures following Assisted Cycle Therapy (AC) in adolescence with Down syndrome (DS). Our study investigated whether we would find improvements in mental health in older adults with DS as measured from the Adapted Behavior Dementia Questionnaire (ABDQ), Physical Activity Self Efficacy Scales (PACES), Children's Depressive inventory, which are early indicators of Alzheimer's disease (AD) in persons with Down syndrome. This study consisted of seven participants with Down syndrome between the ages of 31 and 54, inclusive, that cycled for 30 minutes 3 x/week for eight weeks either at their voluntary cycling rate (VC) or approximately 35% faster with the help of a mechanical motor (ACT). Our results were consistent with our prediction that self efficacy improved following ACT, but not VC. However, our results were not consistent with our prediction that dementia and depression were improved following ACT more than VC. These results were interpreted with respect to the effects of exercise in older adults with DS. Future research should focus on recruiting more participants, especially those with deficits in mental health.
ContributorsPandya, Sachin (Author) / Ringenbach, Shannon (Thesis director) / Coon, David (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Introduction/Purpose: This paper describes the process of the community needs assessment phase of program implementation for the Student Health Outreach for Wellness (SHOW) clinic. Homeless individuals are more likely (than non homeless individuals) to experience serious illness, depression and mental illness. Access to health care has been identified as a barrier to receiving appropriate health care to manage the diseases and conditions clients may have. SHOW's vision is to operate on Saturdays utilizing Health Care for the Homeless (HCH) to offer extended primary health care hours, along with offering health promotion programming to address the biopsychosocial components of their health. Ultimately, this aims to reduce the homeless population's need to visit emergency room departments for non- urgent, primary care visits. Methods: To validate the need for this clinic's operation of programming and health services, a community needs assessment was conducted to collect data about the population's current health status. Forty-three people (n=43) ages 20-76 (M = 44.87) were surveyed by a trained research team using interview questionnaires. Results: The results show a prevalence of self\u2014reported physical and behavioral conditions, and support that this population would benefit from extended hours of care. Mental and behavioral health conditions are the most prevalent conditions (with the highest rates of depression (41.86%) and anxiety disorder (32.56%)), followed by the common cold (23.36%) and back pain (16.28%). The average reported emergency department (ED) visits within the past six months was 1.18 times. Almost everyone surveyed would visit a free medical clinic on the Human Services Campus (HSC) staffed by health staff and health professional students on the weekends (93.18%). Conclusion: Overall, the community needs assessment conducted for SHOW supports the need for weekend access to health care facilities and an interest in health programming for this population.
ContributorsShqalsi, Eneida Agustin (Author) / Hoffner, Kristin (Thesis director) / Harrell, Susan (Committee member) / Harper, Erin (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
Description
The purpose of this study was to examine the influence of Assisted Cycling Therapy (ACT) on depression in older adults with Down Syndrome (DS). We predicted that older adults with Down Syndrome would see an improvement in their depressive symptoms after ACT and Voluntary Cycling (VC). However, we predicted there would be a greater improvement in depressive symptoms after ACT in comparison to VC. Depression was measured using a modified version of the Children's Depression Inventory 2 (CDI 2) due to the low mental age of our participant population. Twenty-one older adults with DS were randomly assigned to one of three interventions, which took place over an eight-week period of time. Eleven older adults with DS completed the ACT intervention, which is stationary cycling on a recumbent bicycle with the assistance of a motor to maintain a cadence at least 35% greater than the rate of voluntary cycling. Nine participants completed the voluntary cycling intervention, where they cycled at a cadence of their choosing. One participant composed our no cycling control group. No intervention group reached results that achieved a conventional level of significance. However, there was a trend for depression to increase after 8 weeks throughout all three intervention groups. We did see a slightly slower regression of depression in the ACT group than the VC and control. Our results were discussed with respect to social and cognitive factors relevant to older adults with DS and the subjective nature of the CDI2. This study brings attention to the lack of accurate measures and standardized research methods created for populations with intellectual disabilities in regards to research.
ContributorsBeaman, Emily Kiernan (Author) / Ringenbach, Shannon (Thesis director) / Bosch, Pamela (Committee member) / Department of Management and Entrepreneurship (Contributor) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.
ContributorsMousa, Mohammad (Co-author) / Mousa, Bakir (Co-author) / Johnson, Ross (Co-author) / Harrell, Liz (Thesis director) / Saewert, Karen (Committee member) / Harrington Bioengineering Program (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
ContributorsWilson, Ethan Sinead (Author) / Jehn, Megan (Thesis director) / Harrell, Susan (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
Cultural beliefs and behaviors can serve as both risk and protective processes for Latino adolescents, with some recent empirical work suggesting the important protective role of bicultural values (e.g., endorsing high levels of both mainstream culture and culture of origin). We expanded on past research to explore whether bicultural values were associated with internalizing (depressive, anxiety, stress) symptoms and externalizing (alcohol use) symptoms among a sample of Latino adolescents preparing to begin college. We hypothesized biculturalism to protect against all negative outcomes. Our sample consisted of 209 college-bound Latino adolescents (65% female; 85.1% Mexican descent; 10.6% 1st generation, 62% 2nd generation) who were enrolled in university for the coming fall. All multivariate models included sex, ethnicity, parent education, and immigrant generation status as covariates. Correlations and multivariate analyses revealed that higher bicultural values were associated with lower depressive symptoms, lower anxiety symptoms, lower stress, and greater alcohol use. Gender was shown to moderate the relationship between biculturalism and alcohol use. Overall, findings suggested that greater bicultural values were associated with lower endorsement of internalizing symptoms for all participants, but higher endorsement of alcohol use over the last year for the highly bicultural females. Biculturalism may be particularly protective for Latino adolescents who are preparing to attend college given the need for them to transition into an environment with high acculturative demands. However, our results also highlight that these bicultural females may be at greater risk for alcohol use and related problems.
ContributorsDilgert, Janice (Author) / Doane, Leah (Thesis director) / Thompson, Daisy (Committee member) / Department of Psychology (Contributor) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
Abstract Objective: The purpose of this study was to determine the feasibility (e.g., practicality and demand) of a 4-week series of yoga classes in a homeless shelter. Participants: Five current residents of Central Arizona Shelter Services (CASS) and the Chief of Programming at CASS. Methods: Each shelter resident participated in a 5-minute interview answering questions regarding the demand of implementing a yoga program at CASS. The Chief of Programming participated in a 30-minute interview answering questions regarding the practicality of implementing a 4-week series yoga program at the homeless shelter. Results: CASS residents reported a strong desire to attend a yoga program. The Chief of Programming at CASS reported that implementing a yoga program would conflict with the overall goal of the shelter. Conclusion: Implementing a 4-week series yoga program is not feasible at CASS although there is a strong demand for a yoga program among the homeless population of the Phoenix metro area.
ContributorsSamuels, Jasmyne Angelique (Author) / Hart, Teresa (Thesis director) / Huberty, Jennifer (Committee member) / Pearl, Julia (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
The aim of this study is to understand the relationship among physical fitness, leisure-time activity levels, measures of body composition, and assessments of emotion toward physical activity in individuals with Down syndrome (DS). This is important because it could help individuals understand the importance of physical activity in this population. The BMI, waist circumference, height, weight, body fat percentage, and non-exercise estimation of aerobic capacity along with the temporary state of emotion toward physical activity of thirty participants with DS were measured. The results of our study show that individuals with DS who are more physically fit have less body fat and a lower BMI. They also took part in more leisure-time activity and expressed more effort during physical activity.
ContributorsSnow, Michelle Jeannette (Author) / Ringenbach, Shannon (Thesis director) / Chen, Chih-Chia (Committee member) / Maraj, Brian (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2013-05
Description
The Student Health Outreach for Wellness (SHOW) is a free, student-led interprofessional clinic and community outreach initiative that aims to serve individuals experiencing homelessness in Phoenix, AZ. Individuals experiencing homelessness face many situational and financial barriers to finding healthcare. In order to better understand these barriers, a community needs assessment (CNA) was conducted in Fall 2014 on the Human Services Campus (HSC), a hub of resources for the population. Results indicated chronic disease is moderately prevalent (37.21% and 27.91% reported obesity and hypertension, respectively, among others). Since chronic diseases can lead to more severe health issues, it is imperative to address, manage, and avoid these conditions. Health education programs are a key component of the SHOW clinic model and a means to address chronic disease. The Health Belief Model (HBM) is a theory-based behavior change model used in programs to increase patient adherence to and promotion of preventative health behaviors. SHOW health education programs will use the constructs of this model to inform program development. Since many student volunteers are not well-versed in health education literature, a SHOW Program Development Guide based on the HBM has been created. The guide will help ensure SHOW delivers high-quality and efficacious programs that have a long-lasting impact on patients now and as the organization continues to grow.
ContributorsReeve, Emma Christine (Author) / Hoffner, Kristin (Thesis director) / Harrell, Susan (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05