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The purpose of the study was to determine the level and type of public policy involvement among registered nurses (RN) who are members of the Arizona Nurses Association (AzNA). Furthermore, the aim of the study was to identify the knowledge base and motivation of nurses and their involvement in public

The purpose of the study was to determine the level and type of public policy involvement among registered nurses (RN) who are members of the Arizona Nurses Association (AzNA). Furthermore, the aim of the study was to identify the knowledge base and motivation of nurses and their involvement in public policy as well as the barriers and benefits. A 20- item survey was sent to all of the members of AzNA. There were 39 responses used in the analysis. The highest reported public policy activities in which the nurses had participated were: voted (90%), contacted a public official (51%), and gave money to a campaign or for a public policy concern (46%). Lack of time was the most frequently reported barrier to involvement and improving the health of the public was the most frequently reported benefit to involvement. The number of public policy education/information sources and the highest level of education positively correlate to the nurses' total number of public policy activities (r = .627 p <0.05; r = .504, p <0.05). Based on the results of stepwise linear regression analysis, the participants' age, number of education/information sources, and efficacy expectation predict 68.8% of involvement in public policy activities. The greater the number of education/information sources, the greater the number of public policy activities nurses report having participated in.
ContributorsHartman, Mykaila Corrine (Author) / Stevens, Carol (Thesis director) / Munoz, Aliria (Committee member) / Link, Denise (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12
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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

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
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Background: In 2012 the U.S. Food and Drug Administration (FDA) approved the drug emtricitabine/tenofovir for use as Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP) after proving to be safe and effective at preventing HIV in multiple peer-reviewed studies. Despite the proven safety and value of PrEP treatment, use remains low

Background: In 2012 the U.S. Food and Drug Administration (FDA) approved the drug emtricitabine/tenofovir for use as Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP) after proving to be safe and effective at preventing HIV in multiple peer-reviewed studies. Despite the proven safety and value of PrEP treatment, use remains low in practice. Research has shown that low clinical use corresponds to low levels of understanding of PrEP among providers. Academic detailing is a method of innovation diffusion through provider education that results in changes in knowledge and practice. The purpose of this project was to investigate the effects of academic detailing on primary care provider knowledge, attitudes, and willingness to prescribe PrEP.

Methods: An academic detailing session was provided by the Florida Department of Health in Broward County to primary care providers (PCPs) at a private clinic in the Southeastern US. The Conceptual Model of Nursing and Population Health (CMNPH) and the Promoting Action on Research Implementation in Health Services Framework (PARIHS) were used as guides for project design and evidence-based practice implementation. There were five participants in the academic detailing session including: a physician, a physician assistant (PA), and three medical students. PCP PrEP knowledge, attitudes, and behaviors were measured using pre and post intervention surveys. PrEP prescription, HIV/Sexually Transmitted Infection (STI) screening, and HIV testing were measured using aggregate data queries for the time periods of four and eight weeks before and four and eight weeks after the educational intervention. No personal identifying information was obtained.

Results: Pre and post surveys were analyzed using Wilcoxon signed rank testing to examine differences between matched pairs of ordinal data. Significant PrEP screening and HIV/STI testing were analyzed pre and post intervention using paired t tests to compare pre and post intervention practices. Significant differences were found in the results (Z = 2.03, 1.84, and 1.83 respectively, p > 0.1) The academic detailing intervention significantly improved knowledge, attitudes, and behaviors of primary care providers and medical students regarding PrEP. The mean of active qualifying ICD 10 codes prior to the intervention versus post intervention were 5 (sd = 5.64) vs. 4.2 (sd = 4.87) respectively. No significant difference was found between active ICD 10 codes for patient visits before compared to after the intervention (t (9) = 1.12, p>.1).

Conclusions: This project found that academic detailing improved provider self-reported knowledge, attitudes, and behaviors regarding PrEP. However, self-reported survey scores were not correlated with changes in clinical practice based on ICD 10 codes. Additional clinical implications may include fostering clinical outreach and cooperation between the county health department and local primary care clinics. Further research is needed on the effects of PrEP academic detailing on clinical practice.
ContributorsSchlumbrecht, Benjamin (Author) / Link, Denise (Thesis advisor)
Created2018-04-18