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Moving towards wellness: designing for the chronically ill 'emerging adult'

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Overview: Transition from the pediatric to adult care setting for 'emerging adults' (ages 18- 26) continues to develop as a growing concern in health care. The Adolescent Transition Program teaches chronically ill 'emerging adults' disease self-management skills while promoting a healthy lifestyle. Transferring this knowledge is vital for successful health…

Overview: Transition from the pediatric to adult care setting for 'emerging adults' (ages 18- 26) continues to develop as a growing concern in health care. The Adolescent Transition Program teaches chronically ill 'emerging adults' disease self-management skills while promoting a healthy lifestyle. Transferring this knowledge is vital for successful health care outcomes. Unfortunately, patients who have been transferred to the adult care setting, report that they felt lost in the system due to lack of communication between care teams, inadequate support systems, and insufficient disease management knowledge. To address these gaps, the design of the physical environment must adapt to these challenges while also meeting the needs of various chronic illnesses. Methodology: Design thinking or human-centered design was utilized as the vehicle to discover unmet 'emerging adult' and adolescent health clinician needs. Ethnographic research methods involved observations at adolescent health clinics and in learning environments outside of the healthcare setting as well as interviews with 5 outpatient adolescent clinicians. A survey was also conducted with 16 'emerging adults' to understand how they learn. Lastly, a literature review explored the history of the adolescent, adolescent development, adolescence and chronic illness, and The Adolescent Transition Program. Results: Findings revealed that physical environment must be conducive to meet a variety of clinical and education activities such as chronic disease management, support adolescent development, and should be more human-centered. The space should transform to the patient education or clinical activity rather than the activity transforming to the space. Five design recommendations were suggested to ensure that the outpatient clinic supported both clinician and 'emerging adults' needs.
ContributorsAlmon, Natalie (Author) / Bernardi, Jose (Thesis advisor) / Takamura, John (Committee member) / Damgaard, Anni (Committee member) / Arizona State University (Publisher)
Created2014
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Learning to doctor on the margin of medicine: the socialization of naturopathic medical students

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This research explores the socialization and culture of naturopathic students. Naturopathic physicians are a rapidly growing group of health care providers with a different ideology than conventional physicians. At present they work on the margins of the division of labor in health care. Only 15 U.S. states explicitly recognize, regulate,…

This research explores the socialization and culture of naturopathic students. Naturopathic physicians are a rapidly growing group of health care providers with a different ideology than conventional physicians. At present they work on the margins of the division of labor in health care. Only 15 U.S. states explicitly recognize, regulate, and license their practice, although the number is increasing. Therefore, the professional socialization of naturopathic students is framed within a context of a changing division of labor in health care. The recent growth of naturopathic physicians reflects the American public's increased interest and use of complementary and alternative medicine (CAM). However, these practitioners are not yet accepted as legitimate physicians by most conventional physicians. This research investigates how the professional socialization of students at a naturopathic medical school prepares them to assume their role as CAM providers in a division of labor that is dominated by conventional physicians. The research examines their choice to attend a naturopathic school, formal and informal socialization at the school, and the student culture. The main research site is a four-year, accredited naturopathic medical school where participant observation, intensive interviews, and a survey were used to collect data. Additional data are presented from observations at a national conference of the American Association of Naturopathic Physicians. Results indicate that the student culture and socialization process at the naturopathic medical school differ in some important ways from the previously documented socialization process at conventional medical schools. The average age of naturopathic students is much older than conventional medical students, and a much larger percentage are women. Unlike conventional medical students, who rely heavily on role models and previous knowledge of what it takes to become a medical doctor, naturopathic students select a career path based on values and beliefs that are more aligned with their own than conventional medicine. The formal and informal training and culture of naturopathic students prepares them to work alongside, rather than within, mainstream medicine. The documentation of how a group of CAM practitioners is created contributes to a better understanding of the ever-changing ideology and division of labor in health care.
ContributorsHarrison, Jennifer L (Author) / Sullivan, Deborah (Thesis advisor) / Kronenfeld, Jennie (Committee member) / Damgaard, Anni (Committee member) / Arizona State University (Publisher)
Created2011
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Development of a Game-Based Intervention to Promote HPV Vaccination Among Adolescents: A Qualitative Analysis

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Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new…

Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new cases yearly. Certain types of HPV have been significantly associated with cervical, vaginal, and vulvar cancers in women; penile cancers in men; and oropharyngeal and anal cancers in both men and women. Despite HPV vaccination being one of the most effective methods in preventing HPV-associated cancers, vaccination rates remain suboptimal in adolescents. Game-based intervention, a novel medium that is popular with adolescents, has been shown to be effective in promoting health behaviors. <br/>Methods: Sample/Sampling. We used purposeful sampling to recruit eight adolescent-parent dyads (N = 16) which represented both sexes (4 boys, 4 girls) and different racial/ethnic groups (White, Black, Latino, Asian American) in the United States. The inclusion criteria for the dyads were: (1) a child aged 11-14 years and his/her parent, and (2) ability to speak, read, write, and understand English. Procedure. After eligible families consented to their participation, semi-structured interviews (each 60-90 minutes long) were conducted with each adolescent-parent dyad in a quiet and private room. Each dyad received $50 to acknowledge their time and effort. Measure. The interview questions consisted of two parts: (a) those related to game design, functioning, and feasibility of implementation; (b) those related to theoretical constructs of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). Data analysis. The interviews were audio-recorded with permission and manually transcribed into textual data. Two researchers confirmed the verbatim transcription. We use pre-developed codes to identify each participant’s responses and organize data and develop themes based on the HBM and TPB constructs. After the analysis was completed, three researchers in the team reviewed the results and discussed the discrepancies until a consensus is reached.<br/>Results: The findings suggested that the most common motivating factors for adolescents’ HPV vaccination were its effectiveness, benefits, convenience, affordable cost, reminders via text, and recommendation by a health care provider. Regarding the content included in the HPV game, participants suggested including information about who and when should receive the vaccine, what is HPV and the vaccination, what are the consequences if infected, the side effects of the vaccine, and where to receive the vaccine. The preferred game design elements were: 15 minutes long, stories about fighting or action, option to choose characters/avatars, motivating factors (i.e., rewards such as allowing users to advance levels and receive coins when correctly answering questions), use of a portable electronic device (e.g., tablet) to deliver the education. Participants were open to multiplayer function which assists in a facilitated conversation about HPV and the HPV vaccine. Overall, the participants concluded enthusiasm for an interactive yet engaging game-based intervention to learn about the HPV vaccine with the goal to increase HPV vaccination in adolescents. <br/>Implications: Tailored educational games have the potential to decrease the stigma of HPV and HPV vaccination, increasing communication between the adolescent, parent, and healthcare provider, as well as increase the overall HPV vaccination rate.
ContributorsBeaman, Abigail Marie (Author) / Chen, Angela Chia-Chen (Thesis director) / Amresh, Ashish (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05