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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

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.

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Created

Date Created
2021-04-12

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Reducing Polypharmacy with Mobile Apps Among Mental Health Patients

Description

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,

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.

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Created

Date Created
2019-04-29