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A Cross-State Longitudinal Study of Opioid-Related Deaths Associated with Opioid and Naloxone Prescribing and Prevention Laws

Description

More than 40% of all U.S. opioid overdose deaths in 2016 involved a prescription opioid, with more than 46 people dying every day from overdoses involving prescription opioids, (CDC, 2017). Over the years, lawmakers have implemented policies and laws to address the opioid epidemic, and many of these vary from…

More than 40% of all U.S. opioid overdose deaths in 2016 involved a prescription opioid, with more than 46 people dying every day from overdoses involving prescription opioids, (CDC, 2017). Over the years, lawmakers have implemented policies and laws to address the opioid epidemic, and many of these vary from state to state. This study will lay out the basic guidelines of common pieces of legislation. It also examines relationships between 6 state-specific prescribing or preventative laws and associated changes in opioid-related deaths using a longitudinal cross-state study design (2007-2015). Specifically, it uses a linear regression to examine changes in state-specific rates of opioid-related deaths after implementation of specific policies, and whether states implementing these policies saw smaller increases than states without these policies. Initial key findings of this study show that three policies have a statistically significant association with opioid related overdose deaths are—Good Samaritan Laws, Standing Order Laws, and Naloxone Liability Laws. Paradoxically, all three policies correlated with an increase in opioid overdose deaths between 2007 and 2016. However, after correcting for the potential spurious relationship between state-specific timing of policy implementation and death rates, two policies have a statistically significant association (alpha <0.05) with opioid overdose death rates. First, the Naloxone Liability Laws were significantly associated with changes in opioid-related deaths and was correlated with a 0.33 log increase in opioid overdose death rates, or a 29% increase. This equates to about 1.39 more deaths per year per 100,000 people. Second, the legislation that allows for 3rd Party Naloxone prescriptions correlated with a 0.33 log decrease in opioid overdose death rates, or a 29% decrease. This equates to 1.39 fewer deaths per year per 100,000 people.

ContributorsDavis, Joshua Alan (Author) / Hruschka, Daniel (Thesis director) / Gaughan, Monica (Committee member) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)

Created2019-05

Increasing College Students’ Health Insurance Literacy: A Curriculum Evaluation

Description

This thesis aimed to create a curriculum for college students to increase their health insurance literacy and to evaluate the impact of the curriculum on participants' confidence. The curriculum for college students consisted of pre-recorded presentation slides covering six health insurance topics, pre- and post-tests, and evaluation questions. Canvas was…

This thesis aimed to create a curriculum for college students to increase their health insurance literacy and to evaluate the impact of the curriculum on participants' confidence. The curriculum for college students consisted of pre-recorded presentation slides covering six health insurance topics, pre- and post-tests, and evaluation questions. Canvas was used to house the curriculum. At the time of evaluation, a total of 12 participants had completed all aspects of the curriculum. The curriculum was evaluated through questions provided at the end of each module. It was found that participants felt the curriculum to be clear and helpful. Moreover, participants reported an increase in confidence, decreased confusion, and were interested in learning more about health insurance such as enrollment. Both the creation of a curriculum and the impact on participants' confidence was successful. At a later point in time, an analysis of the pre- and post-tests will be assessed to determine if the curriculum was effective at increasing health insurance literacy.

ContributorsHernandez, Talia Itzel (Author) / Koskan, Alexis (Thesis director) / Berkel, Cady (Committee member) / School of Politics and Global Studies (Contributor) / School of Life Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)

Created2021-05

Advancing the Implementation of Medication-Assisted Treatment in Residential Treatment

Description

Abstract
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…

Abstract
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.

Keywords: Naloxone, opioid overdose, overdose education, overdose response program

ContributorsQuie, Georgette (Author) / Guthery, Ann (Thesis advisor)

Created2021-04-12

The Effectiveness of Visual Learning in STEM: Evaluation of Visual Cardiology Lessons in Animal Physiology

Description

Visual presentation of information is one method of learning that has the ability to enhance STEM learning compared to learning solely through text. Educational psychology research is ongoing in the STEM field for how students can learn better through visual representations in their course material. The goal of this study…

Visual presentation of information is one method of learning that has the ability to enhance STEM learning compared to learning solely through text. Educational psychology research is ongoing in the STEM field for how students can learn better through visual representations in their course material. The goal of this study was to assess student responses to visual mini-lessons related to course content in the cardiovascular unit in Animal Physiology (BIO360) at Arizona State University. Study participants completed a series of eight mini-lessons and a survey on their experience with the visual lessons. The results of the survey identify increased desire for visual learning materials in STEM courses. The study participants reported that they felt more visual aids in their STEM courses would increase their understanding of course content and that their classroom performance would improve.

ContributorsRauch, Grace (Author) / Hartwell, Leland (Thesis director) / Harrison, Jon (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor)

Created2022-12

Compassion Fatigue Amongst Behavioral Health Workers : A Trauma-Informed Care Approach

Description

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

Advocating for Routine ADHD Screening in Young Girls

Description

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.

ContributorsO'Connell, Roseann (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-04-27

Advancing the Implementation of Medication-Assisted Treatment in Residential Treatment

Description

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.

ContributorsQuie, Georgette (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-04-12

Preschool Teacher Training on Trauma and Resilience

Description

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.

ContributorsChristmas, Melissa (Author) / Guthery, Ann (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)

Created2021-04-12

Exploring the Experiences of Undergraduate Biology Students

Description

This thesis contains three chapters, all of which involve using culturally inclusive education to explore the experiences of religious undergraduate biology students. The first chapter is an essay entitled "Toward Culturally Inclusive Undergraduate Biology Education," which describes a literature review performed with the aim of characterizing the landscape of cultural…

This thesis contains three chapters, all of which involve using culturally inclusive education to explore the experiences of religious undergraduate biology students. The first chapter is an essay entitled "Toward Culturally Inclusive Undergraduate Biology Education," which describes a literature review performed with the aim of characterizing the landscape of cultural competence and related terms for biology educators and biology education researchers. This chapter highlights the use of 16 different terms related to cultural competence and presents these terms, their definitions, and highlights their similarities and differences. This chapter also identifies gaps in the cultural competence literature, and presents a set of recommendations to support better culturally inclusive interventions in undergraduate science education. The second chapter, entitled "Different Evolution Acceptance Instruments Lead to Different Research Findings," describes a study in which the source of 30 years of conflicting research on the relationship between evolution acceptance and evolution understanding was determined. The results of this study showed that different instruments used to measure evolution acceptance sometimes lead to different research results and conclusions. The final chapter, entitled "Believing That Evolution is Atheistic is Associated with Poor Evolution Education Outcomes Among Religious College Students," describes a study characterizing definitions of evolution that religious undergraduate biology students may hold, and examines the impact that those definitions of evolution have on multiple outcome variables. In this study, we found that among the most religious students, those who thought evolution is atheistic were less accepting of evolution, less comfortable learning evolution, and perceived greater conflict between their personal religious beliefs and evolution than those who thought evolution is agnostic.

ContributorsDunlop, Hayley Marie (Author) / Brownell, Sara (Thesis director) / Collins, James (Committee member) / Barnes, M. Elizabeth (Committee member) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)

Created2019-05

Akshara- A Global Initiative

Description

Menstruation - a stigmatized topic and a social taboo- has led to a lack of menstrual hygiene awareness and improper practices impacting women’s health adversely over generations in India. Akshara aims to increase menstrual hygiene education and reduce stigma in India. A creative children’s illustrated book, and interactive workshop curriculum…

Menstruation - a stigmatized topic and a social taboo- has led to a lack of menstrual hygiene awareness and improper practices impacting women’s health adversely over generations in India. Akshara aims to increase menstrual hygiene education and reduce stigma in India. A creative children’s illustrated book, and interactive workshop curriculum about menstruation were designed and published in Hindi and English. Menstrual hygiene workshops, utilizing the designed tools, were conducted in Delhi and Ghaziabad, India to over 230 students through NGO partnerships in December 2018. The response to the menstrual hygiene and stigma workshops was overwhelmingly positive, and a significant increase in the knowledge and awareness survey scores was observed after the curriculum teachings and classroom discussions. This evaluation highlights and provides a potential solution path to eradicate the root cause of the menstruation stigma in underprivileged women through education and open conversations on the topic starting at a pivotal young age. The main aim of the workshop was to help eradicate the stigma associated with menstruation and menstrual health in India through education.

ContributorsBhalla, Jahnavi (Co-author) / Dani, Advika (Co-author) / Schuster, Roseanne (Thesis director) / Hruschka, Daniel (Thesis director) / School of Molecular Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)

Created2019-05

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