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Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine if primary care providers are aware of sex differences in

Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine if primary care providers are aware of sex differences in ADHD and if a brief education on sex differences in ADHD affects the primary care setting's screening rate. Design/Methods: With the Arizona institutional review Boards' approval, primary care providers (PCP) in a Southwest family practice in Arizona (n=35) are provided with virtual education on sex differences in ADHD. Pre- post-intervention surveys were electronically administered to five PCPS. Data were deidentified. A two-tailed paired t-test was conducted to examine the mean difference of responses. Results: Analysis of responses demonstrate that primary care providers are well aware of sex differences in ADHD but screened less for ADHD before the education intervention. Major themes emerged from provider comments on ADHD symptom recognition, time constraints, and increased screening to identify girls in the primary setting. A significant increase in ADHD screening is seen four weeks post-intervention t(4) = -6.32, p = .003. Conclusion: Future research is needed to identify other factors that could strengthen ADHD screening during well-child visits overall. Also, the use of a pediatric screener which can highlight inattentive symptoms would assist in the process of identifying girls with ADHD.
Created2021-04-27
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Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs) towards opioid overdose management and to assess the effect of online training on opioid overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and respond to opioid overdose situations. Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitude

Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs) towards opioid overdose management and to assess the effect of online training on opioid overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and respond to opioid overdose situations. Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in 2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This study was conducted in a residential treatment center (RTC) with the institutional review board's approval from Arizona State University. BHTs aged 18 years and above, working at this RTC were included in the study. Interventions: An online training was provided on opioid overdose response (OOR) and naloxone administration and on when to refer patients with opioid use disorder (OUD) for medication-assisted treatment. Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z = 2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5; 95% CI = 2.5 – 18.7; z =2.02, p = 0.043). Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is effective in increasing attitudes and knowledge related to opioid overdose management. opioid overdose reversal in RTCs.
Created2021-04-12
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Childhood traumatic experiences are a prevalent public health issue. Children exposed to trauma often exhibit behaviors that make educating them challenging. Preschool teachers at a southwestern United States preschool receive no training related to childhood trauma and resilience. The purpose of this project was to educate preschool teachers on trauma and resilience to improve

Childhood traumatic experiences are a prevalent public health issue. Children exposed to trauma often exhibit behaviors that make educating them challenging. Preschool teachers at a southwestern United States preschool receive no training related to childhood trauma and resilience. The purpose of this project was to educate preschool teachers on trauma and resilience to improve attitude related to educating children with trauma. Following Arizona State University Internal Review Board approval, preschool teachers were recruited from a non-profit metropolitan preschool. Project included two pre-training questionnaires (Adult Resilience Measure-Revised [ARM-R] and Attitudes Related to Trauma Informed Care scale [ARTIC]), one two-hour training via Zoom on childhood trauma and resilience, and post-training ARTIC questionnaire at two and six weeks. Seven teachers (n=7) participated in pre-training questionnaires, and three of these teachers (n=3) participated in both post-training questionnaires. All participating teachers were female and Caucasian. Average age of participants was 49.43 years (SD=8.40, range 36-60), and experience average was 17.17 years (SD=10.15, range 3-30). AMR-R average score was 72.29 (SD=8.28, range 61-83). Pre-training ARTIC score average was 3.87 (SD=0.16). Post-training ARTIC scores at two weeks and six weeks post-training were 3.65 (SD=0.22) and 3.86 (SD=0.25). Clinical significance included improved teacher awareness of childhood trauma and improved ability to interact with children exposed to trauma. Teachers exhibited high resilience scores. Additional research needed related to further address educating preschool teachers related to trauma informed care, related to building resilience in children, and related to the impact of teacher resilience on trauma informed care.
Created2021-04-12
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Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.

ContributorsPierce, Albert (Author) / Guthery, Ann (Thesis advisor)
Created2019-04-29
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Background: There is growing evidence that persistent exposure to the adverse effects of stressful work conditions, abuse, and re-traumatization without proper intervention leads to compassion fatigue (CF) and reduced compassion satisfaction (CS). Without appropriate intervention, the outcome of CF affects the patient, staff, and the organization. Despite proposed self-care measures,

Background: There is growing evidence that persistent exposure to the adverse effects of stressful work conditions, abuse, and re-traumatization without proper intervention leads to compassion fatigue (CF) and reduced compassion satisfaction (CS). Without appropriate intervention, the outcome of CF affects the patient, staff, and the organization. Despite proposed self-care measures, mental health (MH) workers continue to struggle with CF and lack the resources to combat the issue. Objectives: Ongoing awareness on the implications of trauma and its impact on one's behavior, supports the use of Trauma-informed care (TIC) skills in creating a conducive work environment. This quality improvement project examines the efficacy of TIC education as an intervention for CF pre/post-one-hour education session among MH workers. Methods: MH nurses (n=8) from diverse backgrounds in a Phoenix inpatient psychiatric hospital gave consent for the study. Participation was sought via flyers and entailed attending the one-hour education session, filling out a demographic, and pre/post-professional quality of life (ProQol) surveys. The ProQol standardized tool measures CF, CS, and burnout with reliability >0.70. Expected outcomes include a reduction in CF and an improvement in CS. Data analysis using intellectus software involved descriptive analysis and paired t-tests to compare outcomes. Results: Pre/post data analysis was statistically significant, P = 0.003, which shows a reduction in CF and an improvement in CS. Conclusion: TIC as an intervention for CF looks promising. MH nurses can manage their stress symptoms and that of their patients using TIC skills.
ContributorsOnyia, Nneka (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-29