Addressing the Mental Health Needs of Patients with Cancer

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Description
Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they

Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The project was guided by the Health Belief Model. Methods: Consent was obtained from 15 participants working as nurse advocates for a large insurance company. Nurse advocates are tasked with improving the health of patients and connecting them to additional resources. A twenty-minute educational intervention focused on the impact cancer has on mental health and the benefit of multiple psychosocial supportive resources was delivered to the participants. Education included a comprehensive review of the resources available for cancer patients at the project site. Participants were then given 10 minutes to complete a retrospective post-then-pre survey, based on a Likert Scale. Results: Statistically significant improvements in survey scores were observed in each of the three KAB domains. Statistical analysis confirmed improvements in survey scores were significant and not likely due to random variation. Participants also referred more patients into a cancer support program following the intervention. Conclusion: A brief educational intervention was able to improve KAB scores among nurses. There was also an increase in the number of patients these nurses referred into a psychosocial supportive program. Nurses that better understand the mental health needs of cancer patients are more likely to connect them with psychosocial resources. This intervention will become part of standard training for new nurse advocates at the project site.
Date Created
2022-05-02
Agent

Humans of SHOW: The Use of Narrative Medicine to Promote Healing and Decrease Stigmatization For Elders Experiencing Homelessness in the Downtown Phoenix Area

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Description
Students from Student Health Outreach for Wellness (SHOW) partnered with Justa Center in Downtown Phoenix, Arizona to interview 10 elders (age 55+) experiencing homelessness. The approach used was narrative medicine with purposes of 1) demonstrate empathy and awareness for the

Students from Student Health Outreach for Wellness (SHOW) partnered with Justa Center in Downtown Phoenix, Arizona to interview 10 elders (age 55+) experiencing homelessness. The approach used was narrative medicine with purposes of 1) demonstrate empathy and awareness for the needs of individuals experiencing homelessness, 2) decrease negative stigmatization surrounding these individuals, and 3) use narrative medicine to promote healing of their traumas. The project results include 30 social media posts for Instagram and Facebook and an approximately 50 minute film featuring all 10 interviews.
Date Created
2022-05
Agent

Humans of SHOW: The Use of Narrative Medicine to Promote Healing and Decrease Stigmatization For Elders Experiencing Homelessness in the Downtown Phoenix Area

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Description

Students from Student Health Outreach for Wellness (SHOW) partnered with Justa Center in Downtown Phoenix, Arizona to interview 10 elders (age 55+) experiencing homelessness. The approach used was narrative medicine with purposes of 1) demonstrate empathy and awareness for the

Students from Student Health Outreach for Wellness (SHOW) partnered with Justa Center in Downtown Phoenix, Arizona to interview 10 elders (age 55+) experiencing homelessness. The approach used was narrative medicine with purposes of 1) demonstrate empathy and awareness for the needs of individuals experiencing homelessness, 2) decrease negative stigmatization surrounding these individuals, and 3) use narrative medicine to promote healing of their traumas. The project's results include 30 social media posts for Instagram and Facebook and an approximately 50 minute film featuring all 10 interviews.

Date Created
2022-05
Agent

Redefine Snitching: Addressing Learned Cultural Behaviors
that Impact Substance Use Recovery

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Description
Purpose: Understanding the factors impacting communication between residents and peer staff in peer-run residential substance abuse treatment programs. The purpose of this paper is to explore male survival behaviors and cultural norms such as no snitching that impede communication to

Purpose: Understanding the factors impacting communication between residents and peer staff in peer-run residential substance abuse treatment programs. The purpose of this paper is to explore male survival behaviors and cultural norms such as no snitching that impede communication to prevent relapse. Methods: The sample was male residents accepted into a residential treatment facility in the southwestern United States. Stories of peer-staff’s personal struggles with the no snitching code videotaped and shown in group followed with a guided discussion of relapse triggers, communication, and behavior norms that impede treatment. An online confidential pre-post retrospective survey designed using the Drug Abstinence Self-Efficacy Scale. Results: Descriptive statistics run show Cronbach's alpha of 0.96. A two-tailed paired samples t-test was conducted to examine the Overall Confidence Pre-test and Post-test mean difference. The overall confidence post-test was not statistically significant, but it was clinically significant. Clinical significance evidenced by residents 3-point lower confidence post-intervention. Conclusions: How-to elicit behavior change is unique to every individual. The goal is behavior change to sustain recovery and better communication between clients and peer staff to prevent relapse.
Date Created
2021-04-26

LifeLine: Mobile Phones and Health Care Continuity for the Homeless

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Description
Due to complexities surrounding healthcare for the homeless, continuity of care is virtually nonexistent. Continuity of care refers to individualized, comprehensive health care services that are timely, accessible, and coordinated. Health care continuity has been demonstrated to reduce mortality and

Due to complexities surrounding healthcare for the homeless, continuity of care is virtually nonexistent. Continuity of care refers to individualized, comprehensive health care services that are timely, accessible, and coordinated. Health care continuity has been demonstrated to reduce mortality and improve health outcomes. A literature review determined access to mobile phones could improve health care continuity among homeless individuals. LifeLine is a state and federal program providing free phones and phone service to impoverished Americans. Enrollment into LifeLine can be challenging for the homeless, who lack access to even the most basic necessities. A project was developed to assist homeless individuals with enrollment into LifeLine in order to increase mobile phone access and improve care continuity. For four weeks, LifeLine enrollment assistance was offered to homeless clients of a mobile health outreach organization in San Francisco, California. Original, anonymous pre- and post-intervention surveys were administered to collect data regarding phone access and healthcare utilization patterns among this population. All 13 participants endorsed mobile phone access; only one participant completed enrollment into LifeLine. Seventy percent of participants reported health care continuity was directly improved by phone access, endorsing consistent healthcare visits and low hospitalization rates. Ninety-two percent of participants reported preexisting awareness of LifeLine, which likely contributed to low program enrollment. This project yielded clinically significant results indicating access to mobile phones can improve health care continuity for the homeless. Improving health care continuity for this population has both ethical and economic implications and remains a public health priority.
Date Created
2021-04-26
Agent

Development of Screening and Education Tool for Social Determinants of Health in Vulnerable Population in Arizona

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Description
Background: This paper details the development of screening and education tools for finding Social Determinants of Health (SDH) in Maricopa County’s vulnerable population. SDH is known as structural or physical differences that hinder everyone to have an equal opportunity for

Background: This paper details the development of screening and education tools for finding Social Determinants of Health (SDH) in Maricopa County’s vulnerable population. SDH is known as structural or physical differences that hinder everyone to have an equal opportunity for improved health, and one of the steps to overcome the differences is through understanding what SDHs are prevalent in the targeted community, so that the community can develop the needed resources. SDH screening process was developed in collaboration with Student Health Outreach for Wellness (SHOW), a student-run organization whose aim is to provide healthcare for underserved populations. SHOW has a unique multi-disciplinary approach of treating each of their patients, and this screening is planned to be implemented during the treatment.
Methods: A literature review was conducted and SDH screening tool were adapted from known SDH screeners, such as Health Leads, PRAPARE, and CLEAR, to fit to the general population that SHOW serves. Training was also developed to educate the student volunteers who will be conducting the SDH screening and included necessary education about the population and the importance of SDH in general. Training materials include a practice scenario, a resources guide, SMART goal sheet, an introduction to the resource guide, and a process flowchart.
Outcomes: This project consists of different versions of screening tools, a training presentation, activities, handouts, and implementation ideas required to succeed in accurate SDH determination.
Date Created
2019-05
Agent

Self-Help Mindfulness Group to Increase Mindfulness and Improve Stress Management in Those with Substance Use Disorders

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Description

Stress is the direct source of some health issues and the precursors to many illnesses. The effects of stress are felt by the majority of the population and is usually undertreated or overlooked as a norm of life rather than

Stress is the direct source of some health issues and the precursors to many illnesses. The effects of stress are felt by the majority of the population and is usually undertreated or overlooked as a norm of life rather than a potential source of illness. Though everyone has different thresholds of stress, chronic or constant stress is debilitating for some and can manifest itself in limitless ways. For adults with substance use disorders (SUDs), research supports that mindfulness based interventions (MBIs) could be beneficial for stress management. The techniques incorporated in mindfulness based practices can decrease the baseline stress of its practitioners by increasing their awareness and mindfulness within daily life and during stressful situations.

This increase in awareness and mindfulness has shown numerous benefits that may be crucial in increasing the likelihood of sobriety for those with SUDs. Some of these benefits may include, improved stress management, improved mitigation of craving symptoms, reduced incidences of relapse, and a better quality of life. A 4-week self-help mindfulness pilot program was conducted twice within two separate residential substance recovery settings. The participant’s satisfaction and the internalization of mindfulness concepts were measured within the pre and post implementation of a self-help mindfulness class. In the pilot program, participants rated high satisfaction of the mindfulness class and showed increased levels of mindfulness through the use of the client satisfaction questionnaire (CSQ-8) and the five facets of mindfulness questionnaire (FFMQ-39).

Date Created
2018-05-01
Agent

Improving Healthcare in the Phoenix Homeless Population Through Triple Aim-Focused Interprofessional Practice

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Description
Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health

Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health for a defined population, 2) enhance the patient care experience, and 3) reduce per capita cost of care. The World Health Organization has identified interprofessional practice (IPP) and interprofessional education (IPE) as a possible approach to achieve the Triple Aim. The Student Health Outreach for Wellness (SHOW) initiative is an interprofessional free clinic and outreach initiative for individuals experiencing homelessness. The goal of the current study was to evaluate whether interprofessional care delivery through SHOW moved SHOW's practice towards the Triple Aim for SHOW's defined population. Methods and Results. Data assessing adherence to Triple Aim goals of population health and costs of care were collected from voluntary post-visit patient satisfaction surveys, while data assessing patient experience were collected from shift rosters of SHOW versus a similar non-interprofessional clinic. SHOW, on average, provided access to more disciplines than a similar non-interprofessional clinic. Access to care cost savings was assessed by surveying patients on where they would have sought care elsewhere SHOW had not been available ; of the 53 patients surveyed, 14 indicated they would have gone to the emergency department (ED); in all, SHOW diverted a little over $30,000 in patient ED visits. Improved health outcomes were measured by each patient's self-perception of his/her health. 91% of patients agreed or strongly agreed that their health had been improved by coming to the clinic. Conclusion. Preliminary data suggest that SHOW's IPP care delivery results in high patient satisfaction rates and positive self-perception of health outcomes, thus may improve the patient experience and minimize costs of care by deterring ED visits within the population. Further studies are needed to determine how specific aspects of interprofessional care can further move towards Triple Aim objectives.
Date Created
2016-05
Agent

Health Education Programming for Pregnant and Parenting Women in an Addiction Treatment Facility

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Description
This paper details the development of a six-week health education class for pregnant and parenting women recovering from substance abuse. The class was developed in collaboration with Student Health Outreach for Wellness (SHOW) Community Initiative, a student-run organization providing free

This paper details the development of a six-week health education class for pregnant and parenting women recovering from substance abuse. The class was developed in collaboration with Student Health Outreach for Wellness (SHOW) Community Initiative, a student-run organization providing free healthcare to underserved populations, and with Crossroads, Inc., a licensed treatment provider serving men, women, and veterans recovering from addiction and substance use disorders. A needs assessment via personal interview was conducted to identify the demographics of the female residents at the Crossroads for Women treatment facility, the existing medical health promotional services, and the needed medical and health promotional services. The needs assessment identified the need for health education for pregnant and parenting women recovering from addiction. The SHOW Program Development Guide was utilized to develop the content for the classes based on the Health Belief Model theory. The Health Belief Model focuses on the beliefs and attitudes of individuals and altering them to make achieving good health more feasible (Hochbaum, Rosenstock, and Kegels, 1952). The program curriculum identifies potential perceived barriers to health and utilizes strategies to decrease the perceived barriers and increase perceived benefits. The six-week course was divided to address six different topics: 1. Introduction, 2. Physical Health, 3. Stress Management, 4. Nutrition, 5. Exercise, and 6. Conclusion and Discharge Planning. The class will be taught by a variety of health professional disciplines in accordance with the interprofessional practice theory, which utilizes two or more health professions to improve health outcomes. This project outlines all presentation materials, handouts, activities, and implementation recommendations required to produce a program that helps pregnant and parenting women on their road to recovery.
Date Created
2016-12
Agent

Comparative Analysis of Interprofessional Clinic Models: Recommendations for Best Practice Implementation

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Description
As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional

As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.
Date Created
2017-05
Agent