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- All Subjects: Academic Detailing
- All Subjects: Opioid-Related Disorders
- Creators: Link, Denise
Description
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
Description
Opioid use disorder (OUD) is a chronic, complex health condition that continues to be a growing problem in the general population, and this increase is paralleled in pregnant women. Pregnancy is a time when women with OUD may be ready to begin a journey of recovery. OUD has both maternal and fetal implications. The safest way to begin recovery during pregnancy is with the initiation of either buprenorphine or methadone to prevent symptoms of withdrawal which can increase risk of fetal harm.
Both medications have the added benefit of being safe to use during lactation. There is a minimal amount of either medication that is found in breastmilk. Breastfeeding during medication assisted recovery (MAR) is linked both to improved maternal and neonatal outcomes, and improved bonding. Often women who are engaged in MAR are unaware of the benefits of breastfeeding initiation and exclusivity. Mothers may perceive breastfeeding as a danger to their baby based on misinformation and bias. Initiation of individualized and nonjudgmental breastfeeding education to women beginning an inpatient MAR program can improve maternal understanding of the benefits of exclusive breastfeeding and increase intention to exclusively breastfeed.
ContributorsSchulte, Brittany (Author) / Link, Denise (Thesis advisor)
Created2020-05-02
Description
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.
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