Heather Young - Academia.edu (original) (raw)
Papers by Heather Young
Innovation in Aging, Nov 1, 2019
Approximately four in ten family caregivers experience high intensity care, based on the number o... more Approximately four in ten family caregivers experience high intensity care, based on the number of caregiving hours, activities of daily living (ADLs) and instrumental ADLs supported for the care recipient. Using the 2015 Caregiving in the U.S. Survey, we examined outcomes associated with high (compared to low or medium) intensity of care. High intensity was positively associated with emotional stress (OR=2.10; 95%CI: 1.52-2.91); financial strain (OR=1.69; 95% CI: 1.210-2.36); physical strain (OR=3.09; 95% CI: 2.21-4.34); and declines in caregiver health (OR=2.14; 95% CI: 1.56-2.93). High intensity was also associated with greater difficulty coordinating recipient care (OR=1.96; 95%CI: 1.42-2.71), higher odds of performing complex medical/nursing tasks (OR=6.85; 95% CI: 5.27-8.90) and, among task performers, greater difficulty performing tasks (OR=2.10; 95% CI: 1.43-3.08). High intensity of care impacts caregiver health and the caregiving role in multiple domains; new clinical and policy approaches are needed to mitigate risks and ensure adequate support.
Innovation in Aging, Nov 1, 2019
Approximately four in ten family caregivers experience high intensity care, based on the number o... more Approximately four in ten family caregivers experience high intensity care, based on the number of caregiving hours, activities of daily living (ADLs) and instrumental ADLs supported for the care recipient. Using the 2015 Caregiving in the U.S. Survey, we examined outcomes associated with high (compared to low or medium) intensity of care. High intensity was positively associated with emotional stress (OR=2.10; 95%CI: 1.52-2.91); financial strain (OR=1.69; 95% CI: 1.210-2.36); physical strain (OR=3.09; 95% CI: 2.21-4.34); and declines in caregiver health (OR=2.14; 95% CI: 1.56-2.93). High intensity was also associated with greater difficulty coordinating recipient care (OR=1.96; 95%CI: 1.42-2.71), higher odds of performing complex medical/nursing tasks (OR=6.85; 95% CI: 5.27-8.90) and, among task performers, greater difficulty performing tasks (OR=2.10; 95% CI: 1.43-3.08). High intensity of care impacts caregiver health and the caregiving role in multiple domains; new clinical and policy approaches are needed to mitigate risks and ensure adequate support.
Research Square (Research Square), Apr 17, 2023
Background: Family-centered rounds is recognized as a best practice for hospitalized children, bu... more Background: Family-centered rounds is recognized as a best practice for hospitalized children, but it has only been possible for children whose families can physically be at the bedside during hospital rounds. The use of telehealth to bring a family member virtually to the child's bedside during rounds is a promising solution. We aim to evaluate the impact of virtual family-centered rounds in the neonatal intensive care unit on parental and neonatal outcomes. Methods: This two-arm cluster randomized controlled trial will randomize families of hospitalized infants to have the option to use telehealth for virtual rounds (intervention) or usual care (control). The intervention-arm families will also have the option to participate in rounds in-person or to not participate in rounds. All eligible infants who are admitted to this single-site neonatal intensive care unit during the study period will be included. Eligibility requires that there be an English-pro cient adult parent or guardian. We will measure participant-level outcome data to test the impact on family-centered rounds attendance, parent experience, family-centered care, parent activation, parent health-related quality of life, length of stay, breastmilk feeding, and neonatal growth. Additionally, we will conduct a mixed methods implementation evaluation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Discussion: The ndings from this trial will increase our understanding about virtual family-centered rounds in the neonatal intensive care unit. The mixed methods implementation evaluation will enhance our understanding about the contextual factors that in uence the implementation and rigorous evaluation of our intervention.
BACKGROUND With the aging population, family caregivers provide increasingly complex and intense ... more BACKGROUND With the aging population, family caregivers provide increasingly complex and intense care for older adults and persons with disabilities. There is growing interest in developing community-based services to support family caregivers. Caregiving occurs around the clock, and caregivers face challenges in accessing community-based services at convenient times owing to the demands of care. Web-based resources hold promise for accessible real-time support. CareNav (TM), a caregiver resource information system, is a web-based platform designed to support real-time universal caregiver assessment, a record of client encounters, development of a care plan, tailored information and resource content, access to web-based caregiver resources, the capacity to track service authorization and contracts, and secure communications. The assessment includes needs and health conditions of both the care recipient and caregiver; current resources; and priorities for support, information, and re...
AJN, American Journal of Nursing, 2018
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published i... more This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers who perform wound care tasks. Each article also includes an informational tear sheet—Information for Family Caregivers—that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregive...
International Psychogeriatrics, 2000
In recent years, pain control has become a topic of increased interest in the United States. Alth... more In recent years, pain control has become a topic of increased interest in the United States. Although the interest originated in professional societies (the American Pain Society has called for pain to be treated as a “fifth vital sign”), regulatory agencies have now picked up on the issue. For example, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), probably the most important of the regulatory agencies, has established standards for pain assessment to be implemented by the upcoming year (JCAHO, 2000).
AJN, American Journal of Nursing, 2018
Innovation in Aging, 2021
A growing body of literature shows that family and unpaid caregivers of older adults with cancer ... more A growing body of literature shows that family and unpaid caregivers of older adults with cancer are assuming more care responsibilities, especially after discharge from an inpatient admission, and frequently report feeling unprepared to do so. Interprofessional collaborative practice can rectify this gap to help ensure caregivers are included in the care team and patient education in the hospital. This retrospective data analysis of electronic health record data examines the prevalence of caregiver involvement in education activities conducted by health care practitioners for older adult cancer inpatients at an academic medical hospital in the midwestern United States. Our dataset includes a total of 676 admissions of older adult cancer inpatients (565 unique patients) between 9/1/2018 and 10/1/2019. Descriptive statistical analyses were conducted to determine the prevalence of caregiver involvement in patient educational activities. The average patient was 75 years old (range: 66-...
Journal of nutrition education and behavior, 2018
We thank you for the opportunity to respond to Dr Lucan 1 with respect to the letter about our ar... more We thank you for the opportunity to respond to Dr Lucan 1 with respect to the letter about our article, "A Multicomponent, School-Based Intervention, the Shaping Healthy Choices Program, Improves Nutrition-Related Outcomes." 2 We acknowledge the points raised in this letter. Based on the comments, additional analyses were conducted on the full data set. These results, along with some amended statements, can be found in a corrigendum published in this issue.
The Gerontologist, 2009
Very few studies have examined cognitive decline in caregivers versus noncaregivers, and only 1 s... more Very few studies have examined cognitive decline in caregivers versus noncaregivers, and only 1 study has examined mediators of such decline. We evaluated the relationship between caregiver status and decline on the digit symbol test (DST; a measure of processing speed, attention, cognitive-motor translation, and visual scanning) and whether this relationship was mediated by depressed mood. Design and Methods: Caregivers for spouses with Alzheimer ' s disease (n = 122) were compared with demographically similar noncaregiver spouses (n = 117) at study entry (Time 1 = T1), T2 (1 year later), and T3 (2 years after T1). Results: Caregivers had lower DST scores and higher Hamilton depression scores at T1, T2, and T3 than noncaregivers (all p < .05). Hierarchical linear modeling revealed that although caregivers started well below noncaregivers, they experienced a more rapid rate of decline than noncaregivers (p = .047). Caregivers declined 4.5 times faster than noncaregivers. Greater depressed mood at T1 (p < .01) and T2 (p < .01) predicted DST decline and mediated DST decline in caregivers vs. noncaregivers. Implications: Depressed mood in caregivers relative to noncaregivers may infl uence their greater risk for DST decline. This is important because the DST predicts problem solving and everyday functions necessary for independent living and the potential well-being of their care recipients.
Research in Gerontological Nursing
The FASEB Journal, 2013
The Shaping Healthy Choices Program (SHCP) involves the integration of five components: nutrition... more The Shaping Healthy Choices Program (SHCP) involves the integration of five components: nutrition education; family and community partnerships; regional agriculture; foods available on school site; and school wellness policies. This study uses a pre‐/post‐test design to test the hypothesis that schools utilizing the SHCP will improve nutrition knowledge, science processing skills, and health‐related behaviors. Schools meeting inclusion criteria were randomly assigned to control (C) or intervention (I) groups. All 4th grade students were invited to participate with a 98% (n=133) and 97% (n=177) rate of participation in C and I schools, respectively. The ethnic diversity index was 63 and 75, and free and reduced‐price eligibility was 30% and 35%, at C and I, respectively. The cornerstone of the SHCP was 20 h of inquiry‐based, garden‐enhanced nutrition education with accompanying parent newsletters. An increased variety of regional produce was available at I schools. The BMI for C and ...
MedEdPORTAL, 2020
Introduction: The imperative of medicine is to treat suffering and to cure when possible. This le... more Introduction: The imperative of medicine is to treat suffering and to cure when possible. This learning module has been designed to expand providers' knowledge of how to sustain life, restore health, relieve suffering, and provide comfort for people who are experiencing cancer-induced pain. The module uses cancer pain as the context through which students can learn interprofessional, team-based, and person-centered approaches to delivery of care. Methods: Using the facilitator's guide, handouts, and other materials developed for this project, the module can be delivered as an in-person training session (approximately 120 minutes) for small groups of learners (teams of eight to 12 students drawn from multiple health care professions or schools). Prelearning materials and postsession activities are included that can enhance the experience. Results: This module was developed and tested with two pilot programs that were evaluated with focus groups, direct observation, and a postsession survey completed by learners. Data demonstrated high approval of and appreciation for the content and structure of the module by both learners and facilitators. Discussion: Many learners work with other health care professionals in their clinical experiences but have not had opportunities to effectively work in interprofessional collaborative practice. This interprofessional education activity allows students from disparate health professions to work together to identify patient-centered treatment options through interprofessional collaborative teamwork in a classroom setting.
AJN, American Journal of Nursing, 2018
Journal of Diabetes Science and Technology, 2019
Through a three-year Patient-Centered Outcomes Research Institute (PCORI) Pipeline to Proposal aw... more Through a three-year Patient-Centered Outcomes Research Institute (PCORI) Pipeline to Proposal award, the Intercultural Diabetes Online Community Research council (iDOCr) was formed to bring together individuals affected by diabetes who engaged in the diabetes online community (DOC) and were interested in studying the impact of online peer support through a comparative effectiveness research (CER) question. Highlighting diversity, the iDOCr council included English-and Spanish-speaking DOC users with type 1 diabetes (T1D) and type 2 diabetes (T2D), advocates, clinicians, caregivers, academics, nonprofit organizations, industry, and researchers. Despite increases in online peer support communities, few studies have used a community-based participatory research (CBPR) approach to engage multiple stakeholders in codesigning a research intervention to examine potential goals and benefits of an online peer support community. 1 Including stakeholders that represent culturally diverse backgrounds allows for a broadening of engagement to those who otherwise may be underserved due to health disparities, and 818455D STXXX10.
JMIR Research Protocols, 2018
Background Chronic diseases, including diabetes mellitus, are the leading cause of mortality and ... more Background Chronic diseases, including diabetes mellitus, are the leading cause of mortality and disability in the United States. Current solutions focus primarily on diagnosis and pharmacological treatment, yet there is increasing evidence that patient-centered models of care are more successful in improving and addressing chronic disease outcomes. Objective The objective of this clinical trial is to evaluate the impact of a mobile health (mHealth) enabled nurse health coaching intervention on self-efficacy among adults with type-2 diabetes mellitus. Methods A randomized controlled trial was conducted at an academic health system in Northern California. A total of 300 participants with type-2 diabetes were scheduled to be enrolled through three primary care clinics. Participants were randomized to either usual care or intervention. All participants received training on use of the health system patient portal. Participants in the intervention arm received six scheduled healthcoaching telephone calls with a registered nurse and were provided with an activity tracker and mobile application that integrated data into the electronic health record (EHR) to track their daily activity and
Patient Education and Counseling, 2019
Objective: Success in diabetes research and self-management is often defined as a significant dec... more Objective: Success in diabetes research and self-management is often defined as a significant decrease in glycated hemoglobin (A1C). The aim of this article is to explore different types of successes experienced by adults with type-2 diabetes participating in a health technology and nurse coaching clinical trial. Methods: A qualitative analysis was conducted using surveys and documentation from motivational interview-based coaching sessions between study nurses and intervention participants.
Research in gerontological nursing, 2017
November is National Caregiving Month, and an annual opportunity to recognize and celebrate the c... more November is National Caregiving Month, and an annual opportunity to recognize and celebrate the contributions that family caregivers make to the health of our nation. Th ey provide more than 80% of long-term care to frail older adults, with an estimated value of $470 billion annually (AARP Research, 2016). Importantly, they make it possible for older adults with serious illness and cognitive and functional defi cits to remain at home, in the place of their choice. Yet, family caregivers are largely invisible in the health care system; much remains to be understood about their experience and their needs, and public recognition and policy fall short of providing adequate support for this vital role. One in fi ve American households is involved in a wide range of caregiving activities that vary in their intensity (National Alliance for Caregiving & AARP, 2015). In 2015, AARP conducted a national survey of family caregiving and found that many family caregivers struggle with tasks that nurses typically perform, referred to as "medical/nursing tasks" (Reinhard, Levine, & Samis, 2012). Th ese tasks include management of medications; dressing changes; handling equipment, such as oxygen tanks; and managing incontinence. Family members typically coordinate complex, fragmented, and even contradictory advice from multiple providers and institutions. Sometimes the need to provide care begins abruptly, immediately following a hospital stay; in other situations, the needs evolve slowly over time, gradually taxing the capacity of families to manage increasingly complex care. Th e demands of family caregiving have implications for the mental, physical, and fi nancial health of those providing this vital service. Th e stress associated with caregiving can go unrecognized by clinicians and threaten quality of life and well-being for care recipients and caregivers.
American journal of medical quality : the official journal of the American College of Medical Quality, 2017
Health care disparities have long existed for racial and ethnic minority populations who continue... more Health care disparities have long existed for racial and ethnic minority populations who continue to lag behind whites in several quality metrics, including quality of care, access to care, timeliness of care, and health outcomes. Effectively addressing these issues requires a health care workforce and leaders who represent the population they serve, and who are deeply committed to reducing health disparities by promoting equity, diversity, and inclusion. Women currently comprise half the population of the United States. Minority groups (any group other than non-Hispanic whites) make up approximately 40% of our population and are projected to comprise the majority of the population over the next 3 decades. 1 Patients report that they are more comfortable communicating with clinicians of the same sex, race/ethnicity, and social background. This enhanced comfort and trust may in turn result in improved health care quality, increased adherence to medical recommendations, and better patient experience of care. 2,3 Despite the imperative for diversity in high-performing teams and organizations, the academic health care pipeline remains more akin to a funnel because of attrition, especially for women and underrepresented minorities. 4,5 This attrition results in loss of diversity of thought and talent, so essential to the long-term success of academic health centers (AHCs). Diversity at the highest levels of leadership at AHCs contributes critical and innovative viewpoints and organizational-level changes that ensure excellent patient care, groundbreaking research, and serve as a model for health professions education. With the goal of identifying strategies to develop the next generation of diverse leaders, the University of California Davis (UC Davis) spearheaded the first University of California (UC) system-wide Health Sciences Leadership Development Conference, held in May 2016. This article summarizes best practices and themes from the conference.
Innovation in Aging, Nov 1, 2019
Approximately four in ten family caregivers experience high intensity care, based on the number o... more Approximately four in ten family caregivers experience high intensity care, based on the number of caregiving hours, activities of daily living (ADLs) and instrumental ADLs supported for the care recipient. Using the 2015 Caregiving in the U.S. Survey, we examined outcomes associated with high (compared to low or medium) intensity of care. High intensity was positively associated with emotional stress (OR=2.10; 95%CI: 1.52-2.91); financial strain (OR=1.69; 95% CI: 1.210-2.36); physical strain (OR=3.09; 95% CI: 2.21-4.34); and declines in caregiver health (OR=2.14; 95% CI: 1.56-2.93). High intensity was also associated with greater difficulty coordinating recipient care (OR=1.96; 95%CI: 1.42-2.71), higher odds of performing complex medical/nursing tasks (OR=6.85; 95% CI: 5.27-8.90) and, among task performers, greater difficulty performing tasks (OR=2.10; 95% CI: 1.43-3.08). High intensity of care impacts caregiver health and the caregiving role in multiple domains; new clinical and policy approaches are needed to mitigate risks and ensure adequate support.
Innovation in Aging, Nov 1, 2019
Approximately four in ten family caregivers experience high intensity care, based on the number o... more Approximately four in ten family caregivers experience high intensity care, based on the number of caregiving hours, activities of daily living (ADLs) and instrumental ADLs supported for the care recipient. Using the 2015 Caregiving in the U.S. Survey, we examined outcomes associated with high (compared to low or medium) intensity of care. High intensity was positively associated with emotional stress (OR=2.10; 95%CI: 1.52-2.91); financial strain (OR=1.69; 95% CI: 1.210-2.36); physical strain (OR=3.09; 95% CI: 2.21-4.34); and declines in caregiver health (OR=2.14; 95% CI: 1.56-2.93). High intensity was also associated with greater difficulty coordinating recipient care (OR=1.96; 95%CI: 1.42-2.71), higher odds of performing complex medical/nursing tasks (OR=6.85; 95% CI: 5.27-8.90) and, among task performers, greater difficulty performing tasks (OR=2.10; 95% CI: 1.43-3.08). High intensity of care impacts caregiver health and the caregiving role in multiple domains; new clinical and policy approaches are needed to mitigate risks and ensure adequate support.
Research Square (Research Square), Apr 17, 2023
Background: Family-centered rounds is recognized as a best practice for hospitalized children, bu... more Background: Family-centered rounds is recognized as a best practice for hospitalized children, but it has only been possible for children whose families can physically be at the bedside during hospital rounds. The use of telehealth to bring a family member virtually to the child's bedside during rounds is a promising solution. We aim to evaluate the impact of virtual family-centered rounds in the neonatal intensive care unit on parental and neonatal outcomes. Methods: This two-arm cluster randomized controlled trial will randomize families of hospitalized infants to have the option to use telehealth for virtual rounds (intervention) or usual care (control). The intervention-arm families will also have the option to participate in rounds in-person or to not participate in rounds. All eligible infants who are admitted to this single-site neonatal intensive care unit during the study period will be included. Eligibility requires that there be an English-pro cient adult parent or guardian. We will measure participant-level outcome data to test the impact on family-centered rounds attendance, parent experience, family-centered care, parent activation, parent health-related quality of life, length of stay, breastmilk feeding, and neonatal growth. Additionally, we will conduct a mixed methods implementation evaluation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Discussion: The ndings from this trial will increase our understanding about virtual family-centered rounds in the neonatal intensive care unit. The mixed methods implementation evaluation will enhance our understanding about the contextual factors that in uence the implementation and rigorous evaluation of our intervention.
BACKGROUND With the aging population, family caregivers provide increasingly complex and intense ... more BACKGROUND With the aging population, family caregivers provide increasingly complex and intense care for older adults and persons with disabilities. There is growing interest in developing community-based services to support family caregivers. Caregiving occurs around the clock, and caregivers face challenges in accessing community-based services at convenient times owing to the demands of care. Web-based resources hold promise for accessible real-time support. CareNav (TM), a caregiver resource information system, is a web-based platform designed to support real-time universal caregiver assessment, a record of client encounters, development of a care plan, tailored information and resource content, access to web-based caregiver resources, the capacity to track service authorization and contracts, and secure communications. The assessment includes needs and health conditions of both the care recipient and caregiver; current resources; and priorities for support, information, and re...
AJN, American Journal of Nursing, 2018
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published i... more This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers who perform wound care tasks. Each article also includes an informational tear sheet—Information for Family Caregivers—that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregive...
International Psychogeriatrics, 2000
In recent years, pain control has become a topic of increased interest in the United States. Alth... more In recent years, pain control has become a topic of increased interest in the United States. Although the interest originated in professional societies (the American Pain Society has called for pain to be treated as a “fifth vital sign”), regulatory agencies have now picked up on the issue. For example, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), probably the most important of the regulatory agencies, has established standards for pain assessment to be implemented by the upcoming year (JCAHO, 2000).
AJN, American Journal of Nursing, 2018
Innovation in Aging, 2021
A growing body of literature shows that family and unpaid caregivers of older adults with cancer ... more A growing body of literature shows that family and unpaid caregivers of older adults with cancer are assuming more care responsibilities, especially after discharge from an inpatient admission, and frequently report feeling unprepared to do so. Interprofessional collaborative practice can rectify this gap to help ensure caregivers are included in the care team and patient education in the hospital. This retrospective data analysis of electronic health record data examines the prevalence of caregiver involvement in education activities conducted by health care practitioners for older adult cancer inpatients at an academic medical hospital in the midwestern United States. Our dataset includes a total of 676 admissions of older adult cancer inpatients (565 unique patients) between 9/1/2018 and 10/1/2019. Descriptive statistical analyses were conducted to determine the prevalence of caregiver involvement in patient educational activities. The average patient was 75 years old (range: 66-...
Journal of nutrition education and behavior, 2018
We thank you for the opportunity to respond to Dr Lucan 1 with respect to the letter about our ar... more We thank you for the opportunity to respond to Dr Lucan 1 with respect to the letter about our article, "A Multicomponent, School-Based Intervention, the Shaping Healthy Choices Program, Improves Nutrition-Related Outcomes." 2 We acknowledge the points raised in this letter. Based on the comments, additional analyses were conducted on the full data set. These results, along with some amended statements, can be found in a corrigendum published in this issue.
The Gerontologist, 2009
Very few studies have examined cognitive decline in caregivers versus noncaregivers, and only 1 s... more Very few studies have examined cognitive decline in caregivers versus noncaregivers, and only 1 study has examined mediators of such decline. We evaluated the relationship between caregiver status and decline on the digit symbol test (DST; a measure of processing speed, attention, cognitive-motor translation, and visual scanning) and whether this relationship was mediated by depressed mood. Design and Methods: Caregivers for spouses with Alzheimer ' s disease (n = 122) were compared with demographically similar noncaregiver spouses (n = 117) at study entry (Time 1 = T1), T2 (1 year later), and T3 (2 years after T1). Results: Caregivers had lower DST scores and higher Hamilton depression scores at T1, T2, and T3 than noncaregivers (all p < .05). Hierarchical linear modeling revealed that although caregivers started well below noncaregivers, they experienced a more rapid rate of decline than noncaregivers (p = .047). Caregivers declined 4.5 times faster than noncaregivers. Greater depressed mood at T1 (p < .01) and T2 (p < .01) predicted DST decline and mediated DST decline in caregivers vs. noncaregivers. Implications: Depressed mood in caregivers relative to noncaregivers may infl uence their greater risk for DST decline. This is important because the DST predicts problem solving and everyday functions necessary for independent living and the potential well-being of their care recipients.
Research in Gerontological Nursing
The FASEB Journal, 2013
The Shaping Healthy Choices Program (SHCP) involves the integration of five components: nutrition... more The Shaping Healthy Choices Program (SHCP) involves the integration of five components: nutrition education; family and community partnerships; regional agriculture; foods available on school site; and school wellness policies. This study uses a pre‐/post‐test design to test the hypothesis that schools utilizing the SHCP will improve nutrition knowledge, science processing skills, and health‐related behaviors. Schools meeting inclusion criteria were randomly assigned to control (C) or intervention (I) groups. All 4th grade students were invited to participate with a 98% (n=133) and 97% (n=177) rate of participation in C and I schools, respectively. The ethnic diversity index was 63 and 75, and free and reduced‐price eligibility was 30% and 35%, at C and I, respectively. The cornerstone of the SHCP was 20 h of inquiry‐based, garden‐enhanced nutrition education with accompanying parent newsletters. An increased variety of regional produce was available at I schools. The BMI for C and ...
MedEdPORTAL, 2020
Introduction: The imperative of medicine is to treat suffering and to cure when possible. This le... more Introduction: The imperative of medicine is to treat suffering and to cure when possible. This learning module has been designed to expand providers' knowledge of how to sustain life, restore health, relieve suffering, and provide comfort for people who are experiencing cancer-induced pain. The module uses cancer pain as the context through which students can learn interprofessional, team-based, and person-centered approaches to delivery of care. Methods: Using the facilitator's guide, handouts, and other materials developed for this project, the module can be delivered as an in-person training session (approximately 120 minutes) for small groups of learners (teams of eight to 12 students drawn from multiple health care professions or schools). Prelearning materials and postsession activities are included that can enhance the experience. Results: This module was developed and tested with two pilot programs that were evaluated with focus groups, direct observation, and a postsession survey completed by learners. Data demonstrated high approval of and appreciation for the content and structure of the module by both learners and facilitators. Discussion: Many learners work with other health care professionals in their clinical experiences but have not had opportunities to effectively work in interprofessional collaborative practice. This interprofessional education activity allows students from disparate health professions to work together to identify patient-centered treatment options through interprofessional collaborative teamwork in a classroom setting.
AJN, American Journal of Nursing, 2018
Journal of Diabetes Science and Technology, 2019
Through a three-year Patient-Centered Outcomes Research Institute (PCORI) Pipeline to Proposal aw... more Through a three-year Patient-Centered Outcomes Research Institute (PCORI) Pipeline to Proposal award, the Intercultural Diabetes Online Community Research council (iDOCr) was formed to bring together individuals affected by diabetes who engaged in the diabetes online community (DOC) and were interested in studying the impact of online peer support through a comparative effectiveness research (CER) question. Highlighting diversity, the iDOCr council included English-and Spanish-speaking DOC users with type 1 diabetes (T1D) and type 2 diabetes (T2D), advocates, clinicians, caregivers, academics, nonprofit organizations, industry, and researchers. Despite increases in online peer support communities, few studies have used a community-based participatory research (CBPR) approach to engage multiple stakeholders in codesigning a research intervention to examine potential goals and benefits of an online peer support community. 1 Including stakeholders that represent culturally diverse backgrounds allows for a broadening of engagement to those who otherwise may be underserved due to health disparities, and 818455D STXXX10.
JMIR Research Protocols, 2018
Background Chronic diseases, including diabetes mellitus, are the leading cause of mortality and ... more Background Chronic diseases, including diabetes mellitus, are the leading cause of mortality and disability in the United States. Current solutions focus primarily on diagnosis and pharmacological treatment, yet there is increasing evidence that patient-centered models of care are more successful in improving and addressing chronic disease outcomes. Objective The objective of this clinical trial is to evaluate the impact of a mobile health (mHealth) enabled nurse health coaching intervention on self-efficacy among adults with type-2 diabetes mellitus. Methods A randomized controlled trial was conducted at an academic health system in Northern California. A total of 300 participants with type-2 diabetes were scheduled to be enrolled through three primary care clinics. Participants were randomized to either usual care or intervention. All participants received training on use of the health system patient portal. Participants in the intervention arm received six scheduled healthcoaching telephone calls with a registered nurse and were provided with an activity tracker and mobile application that integrated data into the electronic health record (EHR) to track their daily activity and
Patient Education and Counseling, 2019
Objective: Success in diabetes research and self-management is often defined as a significant dec... more Objective: Success in diabetes research and self-management is often defined as a significant decrease in glycated hemoglobin (A1C). The aim of this article is to explore different types of successes experienced by adults with type-2 diabetes participating in a health technology and nurse coaching clinical trial. Methods: A qualitative analysis was conducted using surveys and documentation from motivational interview-based coaching sessions between study nurses and intervention participants.
Research in gerontological nursing, 2017
November is National Caregiving Month, and an annual opportunity to recognize and celebrate the c... more November is National Caregiving Month, and an annual opportunity to recognize and celebrate the contributions that family caregivers make to the health of our nation. Th ey provide more than 80% of long-term care to frail older adults, with an estimated value of $470 billion annually (AARP Research, 2016). Importantly, they make it possible for older adults with serious illness and cognitive and functional defi cits to remain at home, in the place of their choice. Yet, family caregivers are largely invisible in the health care system; much remains to be understood about their experience and their needs, and public recognition and policy fall short of providing adequate support for this vital role. One in fi ve American households is involved in a wide range of caregiving activities that vary in their intensity (National Alliance for Caregiving & AARP, 2015). In 2015, AARP conducted a national survey of family caregiving and found that many family caregivers struggle with tasks that nurses typically perform, referred to as "medical/nursing tasks" (Reinhard, Levine, & Samis, 2012). Th ese tasks include management of medications; dressing changes; handling equipment, such as oxygen tanks; and managing incontinence. Family members typically coordinate complex, fragmented, and even contradictory advice from multiple providers and institutions. Sometimes the need to provide care begins abruptly, immediately following a hospital stay; in other situations, the needs evolve slowly over time, gradually taxing the capacity of families to manage increasingly complex care. Th e demands of family caregiving have implications for the mental, physical, and fi nancial health of those providing this vital service. Th e stress associated with caregiving can go unrecognized by clinicians and threaten quality of life and well-being for care recipients and caregivers.
American journal of medical quality : the official journal of the American College of Medical Quality, 2017
Health care disparities have long existed for racial and ethnic minority populations who continue... more Health care disparities have long existed for racial and ethnic minority populations who continue to lag behind whites in several quality metrics, including quality of care, access to care, timeliness of care, and health outcomes. Effectively addressing these issues requires a health care workforce and leaders who represent the population they serve, and who are deeply committed to reducing health disparities by promoting equity, diversity, and inclusion. Women currently comprise half the population of the United States. Minority groups (any group other than non-Hispanic whites) make up approximately 40% of our population and are projected to comprise the majority of the population over the next 3 decades. 1 Patients report that they are more comfortable communicating with clinicians of the same sex, race/ethnicity, and social background. This enhanced comfort and trust may in turn result in improved health care quality, increased adherence to medical recommendations, and better patient experience of care. 2,3 Despite the imperative for diversity in high-performing teams and organizations, the academic health care pipeline remains more akin to a funnel because of attrition, especially for women and underrepresented minorities. 4,5 This attrition results in loss of diversity of thought and talent, so essential to the long-term success of academic health centers (AHCs). Diversity at the highest levels of leadership at AHCs contributes critical and innovative viewpoints and organizational-level changes that ensure excellent patient care, groundbreaking research, and serve as a model for health professions education. With the goal of identifying strategies to develop the next generation of diverse leaders, the University of California Davis (UC Davis) spearheaded the first University of California (UC) system-wide Health Sciences Leadership Development Conference, held in May 2016. This article summarizes best practices and themes from the conference.