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- Creators: Arizona State University. College of Nursing & Healthcare Innovation
- Creators: Link, Denise
- Creators: Barrett, The Honors College
- Resource Type: Text
- Status: Published
Description
A cost analysis was done on the participant recruitment for an ongoing research project to promote colon cancer screening in Phoenix, Arizona. The aim of the 5-year project is to navigate people, who do not regularly see primary care physicians, from the community to a nearby clinic to be screened, using an intervention strategy called tailored navigation. Through tailored navigation, participants' barriers to being screened are addressed by Community Health Navigators, who call the participant over the span of 8 weeks following an initial class at a community site and give them information on how to overcome his or her specific barrier. The objective of this cost analysis is to explore the costs of recruiting a participant from the community to the initial class to a potential program manager. The process of recruitment involved recruitment of a community site, project introduction, the sign-up of interested participants, eligibility, baseline, and consent tests, and the class itself. A Community Site Liaison recruits sites and schedules class times. The Community Health Navigator conducts eligibility, baseline, and consent surveys and teaches the class, a sixty minute presentation on colon cancer screening. The cost of recruitment per community site was $541.23, and the cost per participant attending class was estimated to be $1,594.41 per participant with variation between $1,379.97 and $1,770.71 in optimistic and conservative scenarios, respectively.
ContributorsMishra, Shovna (Author) / Koretz, Lora (Thesis director) / Larkey, Linda (Committee member) / Herman, Patricia M. (Committee member) / Barrett, The Honors College (Contributor) / W. P. Carey School of Business (Contributor) / Department of Management (Contributor)
Created2014-05
Description
The knowledge of medical genetics is currently used with prenatal testing, and the advancements in the field of behavioral genetics may someday allow for its use with prenatal testing as well. The use of prenatal procedures for medical phenotypes has its own implications and should these techniques be used for behavioral phenotypes, such implications can also apply. The complexity of behavior in terms of the factors that may affect it, along with the way it is conceptualized and perceived, adds further implications for prenatal testing of it. In this thesis, I discuss the qualitative, quantitative, and historical facets of prenatal testing for medical and behavioral phenotypes and the undercurrent of eugenics. I do so by presenting an example of the medical phenotype (cystic fibrosis) as a case for envisioning the implications of medical phenotypes before delving into examples of behavioral phenotypes (aggression, impulsivity, extraversion, and neuroticism) in order to explore the implications shared with those for medical phenotypes as well as those unique to it. These implications then set the foundation for a discussion of eugenics, and the considerations for how behavioral genetics with prenatal testing may give way to a modern form of it.
ContributorsMinai, Mandana (Author) / Maienschein, Jane (Thesis director) / Robert, Jason (Committee member) / Magnus, David (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / Department of Psychology (Contributor)
Created2014-05
Description
Purpose/Background: Children exposed to adverse childhood experiences (ACEs) and toxic stress have an increased risk of developing chronic illness and early death in the absence of protective factors. Many providers feel inadequately prepared to screen for and treat ACEs. This quality improvement project, based on the Health Belief Model, investigated if providing ACEs education before a screening program is effective in improving attitudes, knowledge, and the number of completed screenings. Method: The project was conducted at a pediatric primary care practice in the southwestern United States. All providers voluntarily consented to attend four education sessions: 1) Trauma overview, 2) Trauma physiology, 3) Trauma-informed care, 4) Screening tool/referral process. An anonymous pre/post-education Likert-Scale survey was completed to assess knowledge and attitudes about ACEs and screening. The number of completed ACEs screening tools and referrals made were collected four- and eight-weeks post-implementation. Results: Data were analyzed using Intellectus Statistics SoftwareTM. There was a significant increase in ACEs knowledge from the pre-test (p= .011, ?=.05). There was not a significant change in attitudes from the pre-test (p=.066, ?=.05). However, the mean pre- to post-survey scores increased for both categories, indicating improved attitudes. Over the first four weeks, 75% of eligible children were screened and 6% were referred to an ACEs resource program. In the second four weeks, 56% of children were screened and 8.6% were referred. Discussion: A comprehensive education program for providers can improve knowledge about ACEs screening, leading to improved screening practices, early identification, and the introduction of protective resources.
ContributorsChaisson, Charlotte (Author) / Jacobson, Diana (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Introduction: Electronic cigarettes (e-cigarettes) among youth has increased drastically in recent years. E-cigarettes are being used with nicotine which can lead to dependency. Healthcare providers (HPs) are in a unique position to advise against the use of e-cigarettes. Recent studies report a lack of formal education among HPs about e-cigarettes. The purpose of this quality improvement project is to examine how increasing e-cigarette awareness among HPs can change their behavior on patient counseling against e-cigarette use. Methods: A modified E-cigarette Knowledge, Beliefs and Attitude Questionnaire was proctored before and after a virtual educational training about e-cigarettes. All advanced HPs employed, in a Southwestern state, at the organization were invited to participate by email. Results: 29 participants completed the pre-survey, and 4 participants completed the post-survey. While 90% of the participants reported that they first learned about e-cigarettes through informal sources, 72% of the participants reported interest in learning more about e-cigarettes to enhance their practice. Further, a two-tailed Mann-Whitney U test was significant on the “e-cigarettes are helpful aid for smoking cessation” statement based on an alpha value of 0.05, U = 12, z = -2.69, p = .007. Conclusions: Increasing the knowledge about e-cigarettes among HPs is critical in decreasing nicotine use among the public. This project will help in the fight against the use of tobacco products, and adds to the literature on how formal education about e-cigarettes among HPs can increase their intention to screen and counsel patients.
ContributorsWelch, Analuisa (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-01
Description
Problem Statement & Purpose: Cervical cancer screening rates for a Federally Qualified Health Center (FQHC) in rural Northern Arizona is 78%, which is below the Healthy People 2030 goal of 84.3%. Identification of socioeconomic barriers unique to rural women through the use of an intake survey can improve cervical cancer screening rates. This project was guided by the Social Cognitive Theory (SCT). SCT proposes that behavioral change is determined by environmental, social, personal, and behavioral elements.
Methods: At a one-day well-woman event called, “See, Test, and Treat” hosted by the FQHC, an anonymous intake survey was implemented that identified participant demographics, basic cervical cancer knowledge, and perceived socioeconomic barriers to routine cervical cancer screening. Participants were recruited through the FQHC. Participant inclusion criteria: Arizona resident, uninsured, underinsured, 21-65 years old, English or Spanish speaking.
Results: Descriptive statistics were utilized to evaluate the survey responses, reliability, and validity of responses unknown due to self-reported responses. A total of 18 surveys were completed with a final yield of (n = 10). Surveys didn’t identify barriers to routine cervical cancer screening; however, an unawareness of cervical cancer risk factors including multiple sexual partners (n = 5, 50.00%), sex at an early age (n = 4, 40.00%), and misperception that cervical cancer is genetic (n = 7, 70.00%) was identified.
Implications for Practice: A need for cervical cancer education exists within the surveyed community. Providing rural women with knowledge regarding cervical cancer can improve screening rates.
ContributorsParkman, T. Lacey (Author) / Janicek, Patricia (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Purpose & Background: This project evaluates the impact of education on a provider’s intent to screen for vitamin D deficiency in adults with depression. An internal Quality Improvement (QI) study at a local mental health primary care clinic revealed that only 1 in 3 patients with depression were routinely screened for vitamin D deficiency. Vitamin D is a crucial component of numerous systemic functions, including mental health, specifically depression.
Methods: This QI project used the Rosswurm and Larrabee Model implementation framework. Institution Review Board (IRB) expedited review approval was received. This project was conducted at 10 Veteran’s Affairs (VA) primary care clinics in Arizona. An initial email with a recruitment flyer was sent to providers to launch the project. A second email was
sent to participants who volunteered to participate in the project, with instructions and links to the asynchronous pre-survey, recorded education PowerPoint, and post-survey. Responses were analyzed using Intellectus Statistics software.
Results: Provider knowledge of impact and intent to screen for vitamin D deficiency increased after viewing a brief education video (n=30). Frequency distribution analyses revealed a 23% average increase in agreement to screen for vitamin D deficiency at annual visits, “at-risk” individuals, knowledge of the association, and intent to screen regularly in depression.
Conclusion: The education intervention was found to positively impact the provider’s intent and demonstrate the importance of screening for vitamin D deficiency in adults with depression.
ContributorsMiller, Evangelina (Author) / Medland, Jacqueline (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
The physiologic changes that occur during pregnancy can increase risk of maternal periodontal disease. This is more often observed in women seeking prenatal care in community health centers. Poor oral health in pregnancy can negatively impact birth outcomes and the oral health of children born to mothers with a history of perinatal periodontal disease. Despite the evidence of importance and safety, oral health continues to be overlooked during prenatal care visits. There is a lack of interprofessional collaboration between prenatal and dental providers leading to missed opportunities and preventable adverse maternal and fetal health outcomes. Several professional organizations have affirmed that dental care and treatment during pregnancy is safe and recommended to prevent complications during and after pregnancy. In previous studies, barriers preventing pregnant women from receiving oral health exams, oral health education, and referrals include lack of provider awareness regarding the importance of oral health, lack of dental coverage for pregnant women, and reluctance among dental providers to treat women during pregnancy. The Maternal Oral Health Screening (MOS) tool has been used successfully to increase oral health screening in early pregnancy. The MOS was installed in a prenatal care intake form in an electronic health record at a federally qualified health center (FQHC). An education program about oral health care recommendations and safety of oral health care in pregnancy was presented to prenatal care staff. The intervention resulted in increased oral health screening and referral for dental care for pregnant people enrolled at the FQHC.
ContributorsWood, Elizabeth D. (Author) / Link, Denise (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
Description
Maintaining good oral health during pregnancy is a significant contributor to healthy pregnancy outcomes. The physiological changes that happen during pregnancy can adversely affect women’s oral health and place her at risk for pregnancy outcomes such as miscarriage and preeclampsia. The unborn child’s health can also be affected by premature birth and low birth weight. Although professional organizations have evidence-based practice guidelines for both prenatal and dental providers, the evidence shows a gap between recommendations and practice. An oral health promotion project for pregnant women was implemented in a federally qualified community health center where there was a lack of adherence to the guidelines.
The purpose of this project was to implement established oral health screening guidelines for pregnant women and to increase dental visits among pregnant women. For this project, a two-item maternal oral health-screening tool (MOS) for the prenatal providers was added into the electronic health record to standardize and document oral health screening for pregnant women at their first prenatal visit. After three months of implementation, there was a significant increase in maternal oral health screening and referral. This project may be replicated at any prenatal setting to improve oral health during pregnancy.
ContributorsPhilsy, Jaison (Author) / Link, Denise (Thesis advisor)
Created2018-04-24
Description
Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost, yet screening rates remain suboptimal.
This project evaluated an evidence-based intervention to increase cervical cancer screening among underserved women in a federally qualified health center (FQHC). Female patients ages 21 to 65 years without history of hysterectomy (n=1,710) were sent reminders to their phones through the electronic health record (EHR). The message included educational material about the screening process and an announcement regarding government aid for free or reduced cost screening.
The number of patients who made an appointment after receiving the message was assessed two months later. In total, 156 responses were collected, and 28 patients made an appointment for screening. The most frequently observed category of Ethnicity was Hispanic/Latina (n = 24, 86%). The most frequently observed category of Insurance was Title X (n = 13, 46%). The observations for Age had an average of 41.04 (SD = 9.93). Using an EHR communication function to send motivational reminders has shown some promise for increasing cervical cancer screening, thereby reducing cervical cancer mortality among the underserved.
ContributorsBabb, Maria (Author) / Link, Denise (Thesis advisor)
Created2020-04-18
Description
Congenital syphilis (CS) is increasing at an alarming rate in Arizona. The state health department has recommended increased screening to include the third trimester, but providers in individual counties are not following the recommendation. A literature search and appraisal showed increased screening reduces the incidence of CS and presented interventions to increase screening rates. Furthermore, the literature suggests provider education increases screening rates. However, before education could be completed an understanding of providers current knowledge, attitudes, and practice was needed. Using this information, a gap analysis that was completed in an Arizona county (“the County”) of syphilis screening during pregnancy by prenatal care clinicians will be presented guided by the Knowledge-Attitude-Practice (KAP) Model and the ACE Star Model of Knowledge Transformation.
ContributorsWard, Kinley (Author) / Link, Denise (Thesis advisor)
Created2020-04-24