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DescriptionThis study aimed to: (a) examine adolescents' knowledge, attitudes and behavioral intention about HPV and vaccination in adolescent boys and girls aged 11-17; and (b) examine gender differences in responses given by adolescent boys and girls aged 11-17.
ContributorsReidhead, Whitney Brooke (Author) / Chen, Angela (Thesis director) / Stevens, Carol (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
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In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination contributed to the health inequities of people of color in the US, exacerbated by COVID-19-related racism and xenophobia. There is

In a healthcare system already struggling with burnout among its professionals, the COVID-19 pandemic presented a barrage of personal and occupational strife to US healthcare workers. Structural and everyday discrimination contributed to the health inequities of people of color in the US, exacerbated by COVID-19-related racism and xenophobia. There is little research regarding the effects of COVID-19 and related and/or concurring discrimination upon minority nursing staff, despite their importance in supporting the diverse American patient population with culturally competent, tireless care amid the pandemic. This cross-sectional survey study aimed to examine 1) the relationships between discrimination, social support, resilience, and quality of life among minority nursing staff in the US during COVID-19, and 2) the differences of discrimination, social support resilience, and quality of life among minority nursing staff between different racial/ethnic groups during COVID-19. The sample (n = 514) included Black/African American (n = 161, 31.4%), Latinx/Hispanic (n = 131, 25.5%), Asian (n = 87, 17%), Native American/Alaskan Native (n = 69, 13.5%), and Pacific Islander (n = 65, 12.7%) nursing staff from 47 US states. The multiple regression results showed that witnessing discrimination was associated with a lower quality of life score, while higher social support and resilience scores were associated with higher quality of life scores across all racial groups. Furthermore, while participants from all racial groups witnessed and experienced discrimination, Hispanic/Latinx nursing staff experienced discrimination most commonly, alongside having lowest quality of life and highest resilience scores. Native American/Alaskan Native nursing staff had similarly high discrimination and low quality of life, although low resilience scores. Our findings suggest that minority nursing staff who have higher COVID-19 morbidity and mortality rates (Hispanic/Latinx, Native American/Alaskan Native) were left more vulnerable to negative effects from discrimination. Hispanic/Latinx nursing staff reported a relatively higher resilience score than all other groups, potentially attributed to the positive effects of biculturality in the workplace, however, the low average quality of life score suggests a simultaneous erosion of well-being. Compared to all other groups, Native American and Alaskan Native nursing staff’s low resilience and quality of life scores suggest a potential compounding effect of historical trauma affecting their well-being, especially in contrast to Hispanic/Latinx nursing staff. This study has broader implications for research on the lasting effects of COVID-19 on minority healthcare workers’ and communities’ well-being, especially regarding Hispanic/Latinx and Native American/Alaskan Native nursing staff.

ContributorsLaufer, Annika Noreen (Author) / Chen, Angela (Thesis director) / Fries, Kathleen (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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“College Students' Perceived Risk of COVID-19 Infection, Protective Behaviors, and Vaccination Intent” is a thesis project based on research conducted from the end of 2020 to the beginning of 2021. This project investigated various protective behavior factors against the Coronavirus (COVID-19) based on gender, race/ethnicity, and financial difficulty of college

“College Students' Perceived Risk of COVID-19 Infection, Protective Behaviors, and Vaccination Intent” is a thesis project based on research conducted from the end of 2020 to the beginning of 2021. This project investigated various protective behavior factors against the Coronavirus (COVID-19) based on gender, race/ethnicity, and financial difficulty of college students in the United States. The plan for this thesis project was to send out two surveys through Amazon Mturk to a group of 500 college students. The first survey further narrowed down the sample size to include only the participants who met the eligibility factors. A second larger survey was sent to this sample which included the data for this research project. This paper will explore the topics of perceived risk of becoming infected with COVID-19, preventive behaviors, vaccination intent based on gender, race/ethnicity, and financial difficulty.

ContributorsMattingly, Haley Nicole (Author) / Chen, Angela (Thesis director) / Han, SeungYong (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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The purpose of this study was to examine the effect of the comprehensive HPV educational video, “What is HPV?” on the vaccination intent of young adults. The study also aimed to collect information regarding knowledge, attitudes, and beliefs that influence vaccination and related health behaviors. The sample included 215 participants

The purpose of this study was to examine the effect of the comprehensive HPV educational video, “What is HPV?” on the vaccination intent of young adults. The study also aimed to collect information regarding knowledge, attitudes, and beliefs that influence vaccination and related health behaviors. The sample included 215 participants between the ages of 18-26 who had not received any HPV vaccine, were able to read and comprehend English, and had consented for participation through Amazon Mechanical Turk. After they completed the baseline survey (T0), participants were randomly assigned to two study conditions. The intervention group (n = 104) watched the “What is HPV?” video, and the control group (n = 111) read the CDC HPV Fact Sheet. Both groups then completed a post-intervention survey (T1). The analysis results show that the vaccination intent among participants in the intervention group significantly increased following the intervention (59.6% to 71.2%), while vaccination intent significantly decreased for the control group (65.8% to 55%) following the intervention. The results also show a significant difference in the changes in vaccination intent for the two intervention groups. The most change in vaccination intent following the intervention came from the group who was undecided in the initial survey. The findings of the study suggested that a brief HPV educational video that provides the most updated evidence while using non-stigmatizing language and tone has the potential to increase young adults’ vaccination intent to prevent HPV-related cancers and diseases. The findings also suggested that effective HPV education is key to combating negative attitudes and misinformation about HPV vaccines.

ContributorsGlisson, Amber Joy (Author) / Chen, Angela (Thesis director) / Scott, Jason (Committee member) / Reifsnider, Elizabeth (Committee member) / Han, SeungYong (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of youth who experience a major depressive disorder. Teachers and non-teaching

There is an increase in the prevalence of mental health problems in the United States. Healthy People 2020’s leading mental health indicator is to increase the delivery of care to those with mental health issues and lower the number of youth who experience a major depressive disorder. Teachers and non-teaching staff are well placed in the community to identify youth undergoing emotional distress and facilitate early interventions, yet do not receive adequate training in mental health.

A project was undertaken to determine if a mental health training intervention affected the community youth mentors knowledge, attitude and self-efficacy towards helping youth with mental health issues. Three instruments with good validity and reliability namely Mental Health Literacy Scale (MHLS), Attitudes to Severe Mental Illness (ASMI) scale, and Gatekeeper Behavior Scale were used in pre intervention, immediately post intervention and two weeks post intervention questionnaires. The Wilcoxon Signed Ranks test indicated changes in the pre and post intervention scores as significant in knowledge, and attitude between pre intervention and immediately post intervention time periods. Cohen’s effect size value suggested large, medium, small, and minimum clinical significance in the variables over period of time.

Mental health literacy narrows the gap between symptom onset and intervention. Numerous mental health trainings are currently available worldwide. Schools and after school clubs in collaboration with hospital mental health and other community agencies are better equipped to bridge the gap. School staff report better confidence in addressing mental health and behavioral health issues among youth when equipped with additional resources within the school in the form of psychologists, social workers, and counselors.

ContributorsMazhuvencherry, Elizabeth (Author) / Chen, Angela (Thesis advisor)
Created2020-05-03
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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

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.
ContributorsCowart, Amanda (Author) / Chen, Angela (Thesis advisor)
Created2020-05-06
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Background: The shortage of providers, therapists, and long waiting times for appointments in the United States is growing. Mental health technology applications (apps) expand the strategies available to people with mental health conditions to achieve their goals for well being through self-management of symptoms.

Methods: A project was undertaken at

Background: The shortage of providers, therapists, and long waiting times for appointments in the United States is growing. Mental health technology applications (apps) expand the strategies available to people with mental health conditions to achieve their goals for well being through self-management of symptoms.

Methods: A project was undertaken at an outpatient behavioral setting in urban Arizona to determine the use and effectiveness of a mental health app called insight timer to reduce anxiety symptoms. Adult clients with anxiety symptoms were provided with the insight timer app to use over a period of eight weeks. Anxiety was evaluated with the GAD-7 scale initially and after the eight weeks of app use. Usability and the quality of the app were assessed with an app rating scale at the end of the eight weeks.

Results: Findings of the Wilcoxon Signed Ranks test indicated changes in pre and posttest assessment scores as significant (p = .028), which is a significant reduction in anxiety among seven clients who completed the 8-week intervention. the mean TI score was 15.57 (SD = 4.9), and the mean T2 score was 7.71 (SD = 5.7). Besides, Cohen's effect size value (d = 1.465) suggested large clinical significance for GAD7 in pre and posttest.

Discussion: Evidence suggests that the use of an evidence-based app can effectively reduce anxiety symptoms and improve the quality of life. The use of mental health apps like insight timer could reduce health care costs associated with unnecessary hospital admissions as well as re-hospitalizations. The routine use of apps such as the insight timer may also be beneficial to all the clients who have anxiety symptoms in outpatient as well as inpatient settings.
ContributorsJacob, Annie (Author) / Chen, Angela (Thesis advisor)
Created2020-05-06
Description

This research aimed to examine college students’ perceived racial discrimination, mental health, and differences of these variables by US citizenship to promote healthier mental health practices within Asian college students. Mental disorders are a leading cause of suicidal ideation, which is the fourth leading cause of death among teenagers and

This research aimed to examine college students’ perceived racial discrimination, mental health, and differences of these variables by US citizenship to promote healthier mental health practices within Asian college students. Mental disorders are a leading cause of suicidal ideation, which is the fourth leading cause of death among teenagers and young adults, becoming a global phenomenon. The rate of mental health problems, including anxiety and depression, have steadily increased in a decade, with higher rates among racial and ethnic minorities. More than half of adults with serious mental illnesses haven't received treatments, with minorities being more likely to delay or fail seeking mental health treatments due to cultural and structural barriers such as cultural stigma, racial discrimination, acculturation, and language, making it more difficult to address the inaccessibility to high mental health care services, especially for Asians. The findings of this study suggest that, compared to international students, domestic students have greater mental health service seeking intention, received worse racial discrimination (subject to slurs and suspiciousness) and worse mental health since Covid-19, and determined language concordance between patient and healthcare provider is important. International students have more negative beliefs towards the difficulties of treatment and care of mental illnesses and determined ethnicity concordance between patient and healthcare provider is important. The findings provide preliminary insight to acknowledge the differences between domestic and international students in their perceived racial discrimination and mental health. Furthermore, based on findings the issue can be addressed by implementing a mixed-method approach on collecting disaggregated data among this population, removing language and stigmatic barriers to mental health services by education, and promoting cultural competency among mental health workers.

ContributorsNguyen, Evie (Author) / Chen, Angela (Thesis director) / Han, SeungYong (Committee member) / Barrett, The Honors College (Contributor) / School of Molecular Sciences (Contributor)
Created2023-05
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Background: The COVID-19 pandemic has been causing high rates of hospitalization and death among the marginalized Asian American Pacific Islander (AAPI) community. Disaggregated data revealed low COVID-19 vaccine uptake among Korean Americans/Immigrants (KA/I) due to vaccine-related fears unaddressed by cultural and linguistic barriers. Prior evidence demonstrates that digital storytelling (DST)

Background: The COVID-19 pandemic has been causing high rates of hospitalization and death among the marginalized Asian American Pacific Islander (AAPI) community. Disaggregated data revealed low COVID-19 vaccine uptake among Korean Americans/Immigrants (KA/I) due to vaccine-related fears unaddressed by cultural and linguistic barriers. Prior evidence demonstrates that digital storytelling (DST) is an effective medium to improve recommended vaccine intent and uptake among AAPIs. Objective: This DNP project aimed to assess the effect of DST intervention on improving KA/I’s COVID-19-related vaccine hesitancy, intent, and uptake. Methods: A quasi-experimental design was conducted, with participants (n=4) self-identifying as KA/I adults with English or Korean fluency residing in the U.S. Participants were recruited online via convenience sampling from CARE (Collaborative Approach for AAPI Research and Education). Individuals who had already received COVID-19 vaccines were excluded. The intervention included two first-person audiovisual stories documenting the personal experience of receiving the COVID-19 vaccine. Outcomes were measured via a pre-post-1-month-follow-up survey utilizing a modified Vaccine Hesitancy Scale (? = 0.72) and Narrative Quality Assessment Tool (? = 0.78-0.81). Results: DST intervention had a marginally significant effect on lowering post-COVID-19 vaccine hesitancy scores (p = 0.068). Participants (n=2) who rated the DST videos with a higher score indicated vaccine uptake at one-month follow-up. Conclusion: This cost-effective, sustainable, and scalable DST evidence-based project has the potential to promote COVID-19 vaccination among KA/I and other AAPI groups with appropriate modification.
Created2022-05-01
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Purpose & Background: Nurses regularly have encounters with traumatic and stressful events which can have deleterious effects on their physical and psychological well-being and lead to burnout. The Covid-19 pandemic has further exacerbated the stress on nurses. The purpose of this project is to evaluate if an evidence-based, guided mindfulness-based intervention

Purpose & Background: Nurses regularly have encounters with traumatic and stressful events which can have deleterious effects on their physical and psychological well-being and lead to burnout. The Covid-19 pandemic has further exacerbated the stress on nurses. The purpose of this project is to evaluate if an evidence-based, guided mindfulness-based intervention would reduce burnout levels among registered nurses (RNs) working in in-patient settings. Methods: Participants enrolled in nursing programs from a local university were recruited for the project with the following inclusion requirements: (1) RNs working in an in-patient setting, (2) aged 18 years old or older; (3) fluent in the English language. Participants completed a pre-survey and then enrolled in a free mindfulness application via their phone or computer. Participants listened to one ten-minute mindfulness session for a consecutive ten days and then completed a post-survey. Results: Data collected from the pre and post surveys included the use of the following valid and reliable instrument tools: Copenhagen Burnout Inventory, Brief Resiliency Coping Scale, and Short Form Health Survey. Data was analyzed using descriptive statistics and the Wilcoxon Signed Ranks Test. The analyzed data showed that there was statistical significance in decreased burnout levels, increased resiliency, and increased health perceptions of the participants. Conclusion: By finding ways to cope with the experience of burnout in nurses, nurses’ mental health wellness can improve in order for nurses to continue to be an integral part of the healthcare system.
Created2022-05-06