Matching Items (6)
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- All Subjects: Primary Health Care
- Creators: Bay, Sarah
- Creators: Chen, Angela
Description
Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA services, leaving over 50% seeking treatment from civilian providers. Given the high prevalence of Posttraumatic Stress Disorder (PTSD) in the military population, it is imperative to implement a valid and reliable screening tool at primary care facilities to ensure timely and accurate diagnosis and treatment.
Method: This project aimed to provide an evidence-based education for intake nurses to understand prevalence of PTSD and to use a screening tool Primary Care PTSD for DSM-5 (PC-PTSD-5) in a non-VA behavioral health facility.
Setting: The project site was a civilian behavioral health facility located in West Phoenix Metropolitan area. The behavioral health facility serves mental health and substance abuse needs. Project implementation focused on the intake department.
Measures: Sociodemographic data, PTSD diagnosis criteria, prevalence and PC-PTDSD-5 screening tool knowledge collected from pre and posttest evaluation. Patients’ charts for those admitted 6-week before and 6-week after the education to calculate numbers of screening tools completed by nurses at intake assessment.
Data analysis: Descriptive statistics was used to describe the sample and key measures; the Wilcoxon Signed Rank Test was used to examine differences between pre-test and post-test scores. Cohen’s effect size was used to estimate clinical significance.
Results: A total of 23 intake nurses (87.0% female, 65.2% 20-39 years old, 52.2% Caucasian, 95.6% reported having 0-10 years of experience, 56.5% completed Associate’s degree) received the education. For PTSD-related knowledge, the pre-test score (Mdn = 6.00) was significantly lower than the post-test score (Mdn = 10.00; Z= -4.23, p < .001), suggesting an increase of PTSD knowledge among nurses after the education. Regarding the diagnosis, the percentage of patients who were diagnosed with PTSD increased from (0.02% to 20% after the education).
Discussion: An evidence-based education aimed at enhancing intake nurses’ knowledge, confidence and skills implementing a brief and no-cost PTSD screening tool showed positive results, including an increase of PTSD diagnosis. The implementation of this screening tool in a civilian primary mental health care facility was feasible and helped patients connect to PTSD treatment in a timely fashion. Continued use of paper version of screening tool will be maintained at facility as an intermediary solution until final approval through parent company is received to implement into electronic medical records.
Method: This project aimed to provide an evidence-based education for intake nurses to understand prevalence of PTSD and to use a screening tool Primary Care PTSD for DSM-5 (PC-PTSD-5) in a non-VA behavioral health facility.
Setting: The project site was a civilian behavioral health facility located in West Phoenix Metropolitan area. The behavioral health facility serves mental health and substance abuse needs. Project implementation focused on the intake department.
Measures: Sociodemographic data, PTSD diagnosis criteria, prevalence and PC-PTDSD-5 screening tool knowledge collected from pre and posttest evaluation. Patients’ charts for those admitted 6-week before and 6-week after the education to calculate numbers of screening tools completed by nurses at intake assessment.
Data analysis: Descriptive statistics was used to describe the sample and key measures; the Wilcoxon Signed Rank Test was used to examine differences between pre-test and post-test scores. Cohen’s effect size was used to estimate clinical significance.
Results: A total of 23 intake nurses (87.0% female, 65.2% 20-39 years old, 52.2% Caucasian, 95.6% reported having 0-10 years of experience, 56.5% completed Associate’s degree) received the education. For PTSD-related knowledge, the pre-test score (Mdn = 6.00) was significantly lower than the post-test score (Mdn = 10.00; Z= -4.23, p < .001), suggesting an increase of PTSD knowledge among nurses after the education. Regarding the diagnosis, the percentage of patients who were diagnosed with PTSD increased from (0.02% to 20% after the education).
Discussion: An evidence-based education aimed at enhancing intake nurses’ knowledge, confidence and skills implementing a brief and no-cost PTSD screening tool showed positive results, including an increase of PTSD diagnosis. The implementation of this screening tool in a civilian primary mental health care facility was feasible and helped patients connect to PTSD treatment in a timely fashion. Continued use of paper version of screening tool will be maintained at facility as an intermediary solution until final approval through parent company is received to implement into electronic medical records.
ContributorsCowart, Amanda (Author) / Chen, Angela (Thesis advisor)
Created2020-05-06
Description
Purpose: To educate clinic staff on interventions and education materials which are suitable for implementation in a pediatric primary care setting, and to improve delivery and documentation of appropriate asthma interventions and inhaler/spacer education.
Background: Asthma is a chronic illness that impacts 10.9% of the pediatric population in Arizona. Poor asthma understanding and management leads to high-utilization of emergency rooms and urgent care clinics, negatively impacting the healthcare economy. Poor asthma management also leads to decreased health outcomes and impacts on the child’s academic functioning, mental health, and overall quality of life. Current evidence supports use of written asthma action plans (WAAP) and inhaler/spacer instruction to improve asthma management.
Methods: The intervention was an evidence-based educational session provided to the staff of a military, pediatric primary care clinic in southwest Arizona regarding the use of WAAP, the Asthma Control Test (ACT) and integrated inhaler/spacer instruction. Chart reviews were conducted to evaluate the documentation of use of WAAP, ACT, and inhaler/spacer education.
Results: Charts were collected from pre-intervention (n = 33) and post-intervention (n = 18). Data analysis demonstrated a statistically significant higher use of WAAP (U = 0.008, p < 0.05, d = 0.83). Although there was not a statistically significant change in use of ACT tool, Cohen’s value (d = 0.48) suggested a moderate positive effect. A Pearson correlation coefficient was also calculated for the relationship between use of ACT tool and use of WAAP, demonstrating a moderate positive correlation (r (49) = .372, p < .01).
Conclusions: An evidence-based education session for pediatric staff members is a cost-effective and simple method of improving pediatric asthma management practices.
Background: Asthma is a chronic illness that impacts 10.9% of the pediatric population in Arizona. Poor asthma understanding and management leads to high-utilization of emergency rooms and urgent care clinics, negatively impacting the healthcare economy. Poor asthma management also leads to decreased health outcomes and impacts on the child’s academic functioning, mental health, and overall quality of life. Current evidence supports use of written asthma action plans (WAAP) and inhaler/spacer instruction to improve asthma management.
Methods: The intervention was an evidence-based educational session provided to the staff of a military, pediatric primary care clinic in southwest Arizona regarding the use of WAAP, the Asthma Control Test (ACT) and integrated inhaler/spacer instruction. Chart reviews were conducted to evaluate the documentation of use of WAAP, ACT, and inhaler/spacer education.
Results: Charts were collected from pre-intervention (n = 33) and post-intervention (n = 18). Data analysis demonstrated a statistically significant higher use of WAAP (U = 0.008, p < 0.05, d = 0.83). Although there was not a statistically significant change in use of ACT tool, Cohen’s value (d = 0.48) suggested a moderate positive effect. A Pearson correlation coefficient was also calculated for the relationship between use of ACT tool and use of WAAP, demonstrating a moderate positive correlation (r (49) = .372, p < .01).
Conclusions: An evidence-based education session for pediatric staff members is a cost-effective and simple method of improving pediatric asthma management practices.
ContributorsBrown, Jennifer (Author) / Bay, Sarah (Thesis advisor)
Created2019-05-02
Description
Breast or formula feeding is a personal and challenging decision for any new parent. Breastfeeding goes beyond the mother-baby dyad, having profound implications across different societal contexts, including financially and medically. Although a natural form of feeding, breastfeeding can be difficult and isolating if it does not come easily. A mother's first contact for help is usually at her newborn's first primary care appointment. However, these appointments are insufficient in allowing the healthcare provider to answer breastfeeding concerns or questions. A quality improvement project was conducted at a pediatric primary care clinic in the southeast valley of Arizona after approval was granted by an Institutional Review Board. Eight participants were recruited, and four completed the project. This project focused on extending the newborn appointment by 15 minutes to provide an educational resource binder and address breastfeeding questions. The Bristol Breastfeeding Assessment Tool (BBAT) was utilized to determine the mother's self-efficacy towards breastfeeding since the Theory of Self-Efficacy was the foundation for this project. Weekly follow-up telephone calls were conducted to address the mother's questions. The project concluded at the one-month appointment, where BBAT was performed again. The BBAT scores demonstrated an increase in breastfeeding self-efficacy. The participants were also evaluated if the project aided their breastfeeding journey. Every participant was breastfeeding by the one-month appointment except one who was not exclusively breastfeeding. In addition, all preferred the extended-length newborn appointments, educational binder, and weekly phone calls. Qualitative theming supported the use and continuation of the project for future mothers.
ContributorsScott, Taryne (Author) / Bay, Sarah (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-28
Description
Objective
Health care transition (HCT) for adolescents without special health care needs in the primary care setting has received inadequate attention, as represented by national surveys, when compared to adolescents with special health care needs. Barriers to transition such as lack of knowledge and preparation have been known to hinder HCT despite the knowledge gap and weak evidence related to non-special needs adolescent transition. Application of anticipatory guidance education related to care transition may improve transition readiness scores of adolescents without special health care needs.
Methods
Utilizing Meleis’ transition theory with the Plan-Do-Study-Act framework, a quasi-experimental study was conducted comparing transition readiness scores between baseline and intervention groups of adolescents 14 years or older attending their well checks at a small pediatric primary care site. The intervention consisted of two videos developed from Got TransitionTM's (n.d.) Six Core Elements for specific adolescent age ranges.
Results
Statistical analysis reveals that the subgroup and overall transition readiness scores for both age groups, 14-15 and 16-18 years of age, when comparing the baseline groups to the intervention groups, have mixed significance (p = .419, p = .074, respectively). However, when asking the respondents about their understanding of the transition process and their role in that process, 75% and 62.5%, respectively, at minimum agreed the intervention was helpful.
Conclusion
The findings were mixed, indicating the educational videos did have a short-term impact on adolescent transition readiness scores for the 16-18 years old group only. Future focus on long-term follow up throughout the adolescent period may yield better data.
ContributorsJones, Benjamin Keith (Author) / Bay, Sarah (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28
Description
Background: It is estimated that 50% of all mental illness arises prior to age 14, an incident attributed in part to disruptions and imbalances within the family system. Equine assisted learning is a complementary and alternative approach to family therapy which is being used increasingly to promote mental health in both adults and children. This study sought to build and deliver an evidence-based, family-centered equine assisted learning program aimed at promoting family function, family satisfaction and child social-emotional competence, and to measure its acceptability and preliminary effect.
Method: Twenty families with children 10 years and older were recruited to participate in a 3-week equine assisted learning program at a therapeutic riding center in Phoenix, Arizona. Sessions included groundwork activities with horses used to promote life skills using experiential learning theory. The study design included a mixed-method quasi-experimental one-group pretest posttest design using the following mental health instruments: Devereaux Student Strengths Assessment, Brief Family Assessment Measure (3 dimensions), and Family Satisfaction Scale to measure child social-emotional competence, family function, and family satisfaction, respectively. Acceptability was determined using a Likert-type questionnaire with open-ended questions to gain a qualitative thematic perspective of the experience.
Results: Preliminary pretest and posttest comparisons were statistically significant for improvements in family satisfaction (p = 0.001, M = -5.84, SD = 5.63), all three domains of family function (General Scale: p = 0.005, M = 6.84, SD = 9.20; Self-Rating Scale: p = 0.050, M = 6.53, SD = 12.89; and Dyadic Relationship Scale: p = 0.028, M = 3.47, SD = 7.18), and child social-emotional competence (p = 0.015, M = -4.05, SD 5.95). Effect sizes were moderate to large (d > 0.5) for all but one instrument (Self-Rating Scale), suggesting a considerable magnitude of change over the three-week period. The intervention was highly accepted among both children and adults. Themes of proximity, self-discovery, and regard for others emerged during evaluation of qualitative findings. Longitudinal comparisons of baseline and 3-month follow-up remain in-progress, a topic available for future discussion.
Discussion: Results help to validate equine assisted learning as a valuable tool in the promotion of child social-emotional intelligence strengthened in part by the promotion of family function and family satisfaction. For mental health professionals, these results serve as a reminder of the alternatives that are available, as well as the importance of partnerships within the community. For therapeutic riding centers, these results help equine professionals validate their programs and gain a foothold within the scientific community. Additionally, they invite future riding centers to follow course in incorporating evidence into their programs and examining new directions for growth within the mental health community.
Method: Twenty families with children 10 years and older were recruited to participate in a 3-week equine assisted learning program at a therapeutic riding center in Phoenix, Arizona. Sessions included groundwork activities with horses used to promote life skills using experiential learning theory. The study design included a mixed-method quasi-experimental one-group pretest posttest design using the following mental health instruments: Devereaux Student Strengths Assessment, Brief Family Assessment Measure (3 dimensions), and Family Satisfaction Scale to measure child social-emotional competence, family function, and family satisfaction, respectively. Acceptability was determined using a Likert-type questionnaire with open-ended questions to gain a qualitative thematic perspective of the experience.
Results: Preliminary pretest and posttest comparisons were statistically significant for improvements in family satisfaction (p = 0.001, M = -5.84, SD = 5.63), all three domains of family function (General Scale: p = 0.005, M = 6.84, SD = 9.20; Self-Rating Scale: p = 0.050, M = 6.53, SD = 12.89; and Dyadic Relationship Scale: p = 0.028, M = 3.47, SD = 7.18), and child social-emotional competence (p = 0.015, M = -4.05, SD 5.95). Effect sizes were moderate to large (d > 0.5) for all but one instrument (Self-Rating Scale), suggesting a considerable magnitude of change over the three-week period. The intervention was highly accepted among both children and adults. Themes of proximity, self-discovery, and regard for others emerged during evaluation of qualitative findings. Longitudinal comparisons of baseline and 3-month follow-up remain in-progress, a topic available for future discussion.
Discussion: Results help to validate equine assisted learning as a valuable tool in the promotion of child social-emotional intelligence strengthened in part by the promotion of family function and family satisfaction. For mental health professionals, these results serve as a reminder of the alternatives that are available, as well as the importance of partnerships within the community. For therapeutic riding centers, these results help equine professionals validate their programs and gain a foothold within the scientific community. Additionally, they invite future riding centers to follow course in incorporating evidence into their programs and examining new directions for growth within the mental health community.
ContributorsSolarz, Allison (Author) / Chen, Angela (Thesis advisor)
Created2019-05-02
Description
Current obesity statistics exceed national goals with Hispanics disproportionately affected. Evidence suggests a family centered methodology focusing on culture can positively improve weight loss, client satisfaction and participation. This project will evaluate use of culturally tailored resources for primary care providers to educate Hispanics on weight loss. Eight providers in a small practice in the Southwestern US were recruited to complete a pre- and postEBPAS tool after an educational session. A BMI form tracked provider use of the fotonovela intervention against preferred methods.
Feedback on time spent educating and overall perception were collected. Four providers completed the pre-EBPAS, three completed the post-, one participated in the intervention, and six contributed project feedback. Descriptive statistics revealed an aggregate provider decrease of five-points post-educational session for attitude toward adopting EBP. The BMI documentation form demonstrated a 53% (n = 8) use of the fotonovela. However, there were five undocumented fotonovelas taken/given out postintervention. Key themes noted by providers included poor timing of the project, satisfaction with workflow and resources, and overall discontent for the fotonovela. Future implications include re-evaluating the project in a practice not undergoing significant changes with specific focus on timing of the intervention.
ContributorsMunson, Megan A. (Author) / Bay, Sarah (Thesis advisor)
Created2018-04-30