Matching Items (38)
Description
Seclusion and restraint are restrictive interventions that continue to be used in both physical care and mental health care settings as a means of controlling dangerous behavior such as aggression. Restrictive interventions place patients and healthcare staff in hostile situations that can lead to physical, mental, and emotional injuries that can last a lifetime. Unfortunately, restrictive interventions continue to be used in many healthcare organizations around the world and the number of patient and staff injuries continue to rise. Stakeholders at a Phoenix area psychiatric inpatient hospital conducted an internal audit on the number of seclusion and restraint episodes in 2019, which revealed an increase in the number of seclusion and restraints episodes on the adolescent unit.
The result of this audit led to the project question: For nurses on an acute adolescent inpatient unit, is a seclusion and restraint education program more effective than usual
practice in changing the knowledge and attitude regarding seclusion and restraint? The purpose of this practice change project was to provide staff education that focused on trauma informed care, de-escalation techniques, and therapeutic communication to improve staff confidence to ultimately lead to the reduction of seclusion and restraint use on an adolescent inpatient unit. A
pre and posttest questionnaire designed to better understand nurse attitude and knowledge regarding restrictive interventions prior to the education session was provided. A convenience sample of nurses (N=9) participated in the project. The findings from the pre and posttest questionnaire suggest that seclusion and restraint education for nurses may improve nurse knowledge and attitude regarding the use of restrictive interventions and reduce rates of use.
ContributorsMoe, Vanessa (Author) / Guthery, Ann (Thesis advisor)
Created2020-04-21
Description
Implementation challenges associated with low community effectiveness rates include low levels of client responsiveness to the intervention, less than ideal intervention fidelity, and low levels of provider quality of intervention delivery. The literature is mixed on how group leader fidelity/quality of delivery are associated with client responsiveness, and research on adolescents and ethnoracially diverse clients is particularly lacking. The current study examined group leader fidelity and quality of delivery as predictors of adolescent in-session group responsiveness to the first session of the Bridges intervention which is a universal, family-based, substance use prevention program delivered in Title I middle schools. Participants consisted of 325 adolescents across 30 intervention groups. Three separate observational coding teams coded group leader fidelity, group leader quality of delivery, and adolescent in-session group responsiveness to the program. Overall percentage of fidelity met was calculated. Next, two confirmatory factor analysis models were conducted on the responsiveness and quality of delivery data of session 1, and factor scores were extracted. Hierarchical linear regression was then conducted to predict adolescent responsiveness with group leader fidelity in step 1 and group leader quality of delivery in step 2. There were no significant associations between predictor variables and adolescent in-session group responsiveness. Findings suggest that group leader implementation constructs do not appear to account for a significant amount of the variance in adolescent group responsiveness during the first session. Future research should examine other variables that are relevant in influencing adolescent program engagement with larger sample sizes.
ContributorsKuckertz, Mary J (Author) / Gonzales, Nancy (Thesis advisor) / Mauricio, Anne (Committee member) / Anderson, Samantha (Committee member) / Arizona State University (Publisher)
Created2022
Description
An alarming number of youth have mental health concerns, but of those who are diagnosed, only half receive treatment. Using Bandera's social cognitive theory, one can achieve behavioral changes through self-efficacy and control their actions by self-regulation. Mindfulness activities, when implemented early, can decrease stress, and improve well-being in youth.
Methods:
This project was implemented among students attending an alternative high school in Arizona. Nine students participated in four different mindfulness, hands-on activities during two classes- 1 hour each. Participants completed a pre and a post-test with the 10-item questionnaire Perceived Stress Scale (PSS), and a 3-question survey to evaluate the program at the end of the second week.
Results: Among the 9 participants (mean age = 16 SD=2.06), the stress levels were considered low to moderate in the pretest (mean=16.56) and the post-test (mean=15.89). Stress level scores were reduced after the education although the difference was not statistically significant. Furthermore, all participants agreed that the content and activities were appropriate, 88.9% agreed they had a "better understanding of how to reduce stress," and 77.8% stated their "knowledge of stress has improved."
Discussion/Conclusion:
This project aimed to help reduce vulnerable adolescents' stress level through mindfulness activities. Mental health education like this may help adolescents better manage stress and consequently promote their overall well-being. Future projects should recruit a larger sample and implement a longer time for larger and longer effects.
ContributorsQualman, Stephanie (Author) / Chen, Angela (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-10
Description
Mental health challenges are becoming a significant public health issue for adolescents/teenagers, and primary interventions have been focused on mental health education. Because adolescents spend most of their time in school, primary mental health interventions should be prioritized in this setting. A PICOT question was developed to determine if mental health literacy (MHL) in adolescents would improve while decreasing stigma and improving help-seeking behaviors after a program of enhanced mental health education. Partnering with a large Arizona suburban school district social work department, a teen Mental Health First Aid (tMHFA) pilot program was implemented for a class of nine (n = 9) adolescent students (aged 17-18 years) old during the school day. tMHFA was delivered in three 90-minute class days. Using the Mental Health Literacy questionnaire (MHLq), a pre and post-test design revealed a significant (p value=less than 0.05) increase in the students' MHL, help-seeking behaviors, and decreased stigma after delivery. This quality improvement project was IRB approved, and all human subjects' rights were protected. In conclusion, there is strong evidence that enhanced mental health programming, such as tMHFA, effectively educates adolescents about mental health challenges and, perhaps, could promote behavioral changes in future generations.
ContributorsJones, M. Christina (Author) / Schiller, Zita (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-15
Description
Introduction: Depression screening in the pediatric setting is a crucial part of the adolescent's examination. A standardized screening tool and protocol streamlines the process of assessing adolescents and minimizes the chances of serious mental health disorders going undetected and untreated. Evaluation of current evidence demonstrates the use of a standardized tool improves detection, diagnosis, and management of depression and other mental health illnesses.
Method: The Patient Health Questionnaire—modified for adolescents (PHQ9-A) was administered to all eligible adolescents, ages 12-18, during an annual well visit for a period of 6 weeks. Lewin's Change Theory guided a system change in the electronic health record, and the questionnaire results were documented and provided to the pediatric provider at the time of the appointment. A chart review was conducted to determine whether all eligible patients were administered the questionnaire and if a depression diagnosis or mental health referral had been made.
Results: Out of 76 eligible well visits, 65 (86%) patients completed the PHQ9-A. The average score was 5.29 (SD = 6.49) with a maximum score of 25. Out of those that completed screening, 11 (17%) had a positive PHQ9-A score resulting in 8 referrals to mental health services and 2 mental health diagnoses in the clinic.
ContributorsCoomer, Meagan (Author) / Rauton, Monica (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27
Description
Seclusion and restraint (SR) continue to be used in psychiatric settings when a patient is a harm to self or others despite growing concern and calls to eliminate the practice due to its harmful, potentially life-threatening effects on patients. The purpose of this evidence-based project was to assist a hospital in the southwestern United States decrease their seclusion and restraint rates among their adolescent patients. Trauma-informed care approaches have been shown to significantly reduce the incidence of SR in inpatient settings.
The nurses and behavioral health technicians (BHTs) received a two-hour trauma-informed care training in November of 2019. SR rates three months pre-training and post-training were compared. In the three months prior to the training, SR rates averaged 23.4 events per 1000 patient days. Comparatively, the three months after the training SR rates averaged 19.5 events per 1000 patient days. This shows a clinically significant decrease in SR rates after the TIC training. This evidence-based project (EBP) highlights the need to address this problem and gives an intervention option that can reduce harm for patients and address the needs of healthcare organizations seeking to improve patient care.
ContributorsNava, Lidice L. (Author) / Bucci, Aimee (Thesis advisor)
Created2020-05-03
Description
General theories of crime have frequently been used to explain a variety of offending and victimization experiences for a wide range of samples. However, feminist criminologists question whether the same causal mechanisms exert similar effects for males and females—a criticism that points to the need for sex-specific analyses. Toward that end, this dissertation examines variables derived from several different general theories of crime in three separate studies. Each of the studies uses split-sample analyses to investigate potential sex-based differences. The first study uses three-level meta-analytic methods to determine if predictor variables derived from general theories explain victimization for both adolescent males (n = 138,848) and adolescent females (n = 176,611). Additionally, it examines both within-dataset and between-dataset differences. The second study uses a sample of high school students in Arizona (n = 2,738 males, n = 2,932 females). It examines the role of parental social ties in explaining the overlap of adolescent dating violence (ADV) offending and victimization. The third study uses two waves of a longitudinal dataset of high-risk adolescents (n = 182 males, n = 203 females). It focuses on the relationship between negative emotions and delinquency, and the role of avoidant coping. In each of the studies, both gender-neutral and gender-specific explanations of offending and victimization were found. In the first study, while predictor variables derived from criminological theory explained victimization for both males and females, larger effect sizes were found for risky lifestyle variables. In the second study, an overlap between ADV offending and victimization was found for both males and females, and social ties explained some of the overlap. However, paternal attachment was only significant for females, and involvement was only significant for males. In the third study, avoidant coping was associated with an increase in substance abuse, and anger was associated with an increase in violent behavior for both males and females. Avoidant coping partially mediated the relationship between anger and substance use, but only for males. Implications for practice and future research are discussed.
ContributorsPusch, Natasha (Author) / Holtfreter, Kristy (Thesis advisor) / Reisig, Mike (Committee member) / Fine, Adam (Committee member) / Arizona State University (Publisher)
Created2020
Description
Adolescent substance use is a complex and significant public health concern that has received considerable attention among researchers and practitioners (Gray & Squeglia, 2018). The purpose of this dissertation was to examine factors associated with substance use intervention effects and to develop subgroups of risk factors for Mexican adolescents. This dissertation utilizes secondary data from a randomized controlled trial of the school-based substance use universal prevention program, keepin’ it REAL (kiR). The dissertation included two studies. Study 1: This study tested a model on the efficacy of the school-based substance use universal prevention program, keepin’ it REAL, among a sample of Mexican adolescents (N = 3,742, 11-17 years old). Study 1 analysis included Structural Equation Modeling and results demonstrated that participation in kiR positively predicted alcohol resistance strategies and those alcohol resistance strategies were negatively and significantly associated with alcohol use. Further, depressive symptomology was a moderator of intervention effects as the effects of kiR on resistance strategies increased as the level of depressive symptomology increased. Study 2: this study explored subgroups (classes) of Mexican adolescents (N = 5,520, 11-14 years old) based on their experiences with violence (witnessing, victimization, and perpetration), depressive symptomology, and substance use (alcohol, tobacco, and marijuana). Using Latent Class Analysis (LCA) four empirically, well-differentiated classes emerged representing adolescents various risk typologies (Moderate Risk-Violence at 55% of the sample, Low Risk at 35%, High Risk at ~8%; and Moderate Risk-Substance Use at ~2%) Implications for research and practice are discussed across both studies.
ContributorsArévalo Avalos, Marvyn R (Author) / Spanierman, Lisa (Thesis advisor) / Dillon, Frank (Committee member) / Marsiglia, Flavio (Committee member) / Arizona State University (Publisher)
Created2021
Description
This research scrutinizes theatre teaching practice through a teacher perspective to find mechanisms that enable health promotion and quality theatre-making skills for students. The critical investigations conducted are twofold. First, I examine the intersection of my 18 years of experience teaching high school drama for connections to theatre and health research. I employ a narrative inquiry method to analyze lived experience to create an initial health promotion framework. And second, I interrogate that framework investigating the experience of a focus group of other high school drama teachers, a high school counselor, and a psychologist. This study reveals that drama teachers perceive their drama programs as psychologically, socially, and emotionally health-promoting for involved students. Furthermore, this study identifies the complex processes, relationships, and components of the theatre-making that the teachers pinpoint as preconditions and mechanisms that enhance and enable student flourishing. The teachers describe themselves as key to health promotion by modeling the artistry of theatre and the art form's social and emotional skills. Their narratives demonstrate that flexible time, their students, and the relationships they build with them as preconditions to maximize health promotion. Specifically, they identify the creation of a safe, supportive environment as foundational to the process.
ContributorsOlsen, Nicola (Author) / Etheridge-Woodson, Stephani (Thesis advisor) / Underiner, Tamara (Committee member) / McAvoy, Mary (Committee member) / Arizona State University (Publisher)
Created2021
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 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