Matching Items (14)
Description
Purpose: Patient portals are widely available online applications with many health-related tools that facilitate patient engagement and enhance communication with providers yet are highly underutilized. The purpose of this evidence-based practice (EBP) project was to explore an English and Spanish patient portal educational video's impact on patient engagement in a Federally Qualified Health Center (FQHC). The social cognitive theory underpins the project because patients' portal use behavior can change if changing their environmental factors in the clinic with educational videos.
Methods: The Universities Institutional Review Board granted exempt approval to ensure human subject protection. The participants included bilingual adult patients in an FQHC who have access to the internet and email addresses who visited the center during the implementation period. The tablets in the patient rooms displayed the English and Spanish educational video on step-by-step instructions on accessing, using the patient portal, and the benefits of use. The information technology technician pulled aggregate data from the analytics component of the patient portal before and after the four-week implementation period. The data included total number of clinic patients, number of active portal users, number of monthly logins, and gender. The project facilitator used descriptive statistics to compare pre-and post-intervention analytics. Results: Active portal users increased by 0.22% and monthly logins increased by 390 logins.
Only aggregate data was collected so the statistical significance was not calculated. Conclusion: This EBP project enhances knowledge on patient portal utilization's impact on patient engagement and may apply to current practice.
ContributorsHerrera, M. Sara (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-29
Description
Background: Vaccination is an effective public health tool; however, immunization rates are low in American adults, with disparities existing for Hispanics compared to non-Hispanic Caucasians, uninsured individuals, undocumented immigrants, and low-income individuals (Lu et al., 2014; Lu et al., 2015; Williams et al., 2016). Consequently, 42,000 adults still die each year in the United States (US) from vaccine-preventable diseases, and nine billion dollars are spent on associated healthcare costs and lost productivity (ADHS, 2015; Wilson et al., 2019). To improve adult vaccination rates, the National Vaccine Advisory Committee recommends the Standards for Adult Immunization Practices, including regular assessment, recommendation, delivery or referral, and documentation during follow-up on vaccination (Orenstein et al., 2014; CDC, 2016).
Local problem: A free clinic in Arizona serving uninsured, undocumented Latin American immigrants had low vaccination rates and a deficiency in vaccination documentation in electronic medical records.
Methods: An evidence-based quality improvement project was conducted to address low vaccination rates and provider practices using a multi-component intervention. The effect and usage were evaluated through chart audits and pre- post-intervention surveys.
Interventions: A vaccination questionnaire was administered at all in-person primary care visits. Brief educational videos were provided to providers and office staff before the intervention addressing the questionnaire's use, purpose, and goals. Adult immunization schedule printouts were made available in all patient rooms and provider charting areas. Additionally, a resource sheet on local free immunization programs was created for providers and patients.
Results: The intervention's effect was unable to be determined due to a breakdown in the protocol after the second week of implementation. However, 92% of completed questionnaires reviewed indicated the patient needed one or more vaccination. Sixty-five percent of electronic medical records reviewed had no vaccination documentation historically for assessment, recommendation, referral, follow-up, or scanned vaccination records. No charts reviewed had these areas documented regularly.
Conclusion: Vaccination rates and the Standards of Adult Immunization Practices are low at the free clinic. Further quality improvement measures are indicated addressing barriers present.
ContributorsDukes, Alyssa (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
Objective: Mental health illnesses are complex conditions that afflict many university students. International students are uniquely vulnerable to these conditions due to challenges such as adjusting to the new environment and culture of American universities. They are also less likely than domestic students to receive mental health services. Research indicates that there are obstacles for international students when it comes to seeking mental health services, but these obstacles are typically over-generalized and less applicable to each specific university setting. The purpose of this paper was to assess the barriers in seeking mental health services by international students. Participants: International students at a large university located in Southwestern United States. Students 18 years of age or older, enrolled as an international student, proficient in English, exhibiting mental health symptoms, and refusal of primary care physician’s referral to mental health services. Method: Physicians at Health Services verbally recruited the participants during routine visits. Participants did not provide any personal information, and completion of the questionnaire indicated their consent. This project was guided by the model of mental health help-seeking, where a questionnaire was administered to students, allowing them to identify what specifically prevents them from receiving mental health services.
Result: Due to the COVID-19 pandemic, only 1 questionnaire was completed, but it was rejected as it was filled by domestic student. Conclusion: The data gathered through this questionnaire was intended to be provided to university healthcare providers to better understand how they can connect with international students with mental health concerns.
ContributorsSaqib, Syed (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27
Description
Introduction: Pre-exposure prophylaxis (PrEP) is a critical development in HIV prevention, yet females at risk of contracting HIV have lower rates of PrEP use compared to their male counterparts. Insufficient knowledge on PrEP indications for women has been a key barrier in health care providers (HCP) utilization of PrEP in this population. Prior research has revealed educational interventions improved providers’ use of PrEP in at risk populations.
Methods: A 1-hour, educational session was developed for eleven HCPs at a university-based clinic. The educational session was guided by the Cognitive Learning Theory and included information on clinical practice guidelines for PrEP implementation in women. The effects of the intervention were analyzed using a pre/post-survey design, with post surveys delivered at two and eight weeks. The 16-item survey evaluated outcomes including provider discussion and prescription rates of PrEP with female patients and perceived knowledge and perceptions of PrEP in women, utilizing a Likert scale. All procedures were given exempt status by the university IRB.
Results: Paired sample t tests were used to analyze provider reported conversations and prescription rates, while matched ordinal data were analyzed utilizing Wilcoxon signed rank tests and descriptive statistics. At two-weeks post intervention there was a significant increase in provider’s reported likelihood of prescribing to at risk cis gender females in the next six months (Mdn= 2 [pre-survey], Mdn = 3 [post-survey], α= 0.05, V = 0.00, z = -2.53, p = .011). At eight weeks postintervention, there was a statistically significant decrease in provider’s beliefs that HIV risk assessment was an essential component of a primary care visit for female patients (Mdn = 3.00 [pre], Mdn = 2.00 [eight-week], α= 0.05, V = 10.00, z = -2, p = .046). The results of the data analysis have been shared with the leadership team of the health clinic and used to inform future practice on provider educational sessions on PrEP.
Conclusion: Women at risk of contracting HIV are a key demographic missed for the utilization of PrEP. Limited statistically significant findings from the intervention have prompted further research to focus on interventions that promote long-term behavior change and improve providers implementation practices of the preventive measure in at-risk female identifying patients.
ContributorsSnyder, Emily (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-25