2.50
Hdl Handle:
http://hdl.handle.net/10755/152886
Type:
Presentation
Title:
A Test of a Model of Community Nursing for Rural Hispanics
Abstract:
A Test of a Model of Community Nursing for Rural Hispanics
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Ferketich, Sandra, PhD, RN, FAAN
P.I. Institution Name:University of New Mexico HSC
Title:Dean and Professor
This report is of the test of a Comprehensive Multilevel Nursing Practice Model For Rural Hispanics funded by the Agency on Health Care Policy and Research for five years with an additional one-year no-cost extension. Objective: The objective was to test three components of community health nursing in four rural communities on the outcomes of health status and health impact. The components were personalized preventive nursing (PPN), organized indigenous caregivers (OIC), and community empowerment (CE). Design: Four rural communities were randomly assigned (without replacement) to the four treatments in this experimental design. The assignments permitted an examination of the main and/or interaction effects over time of a) the three treatments (PPN, OIC, CE), b) ethnicity and site, c) ethnicity and outcomes of health status d) and ethnicity and health impact. Population, Sample, Setting, Years: There were approximately 10,000 residents, 50% of whom were Hispanic and 50% non-Hispanic white. All subjects were in the sample for the treatment protocols. However, the outcome measure surveys were randomly assigned to different households, with a total 1,400 households across the communities. Three surveys were done over 5 years. These communities were in sparsely populated, underserved areas of Arizona. The communities were economically depressed and highly dependent upon copper mining. The study was conducted from 1990 to 1995 with an additional year for analysis, 1995-1996. Concepts and Variables: Health care availability, accessibility, acceptability and affordability were concepts on which the treatment protocols were based. As part of the Aday and Anderson Model, the impact of these concepts through the treatments was assessed through the outcome variables of Health Status and Health Outcomes. Methods: A team of a community health nurse and promotoras (community lay caregivers) was developed for each community. The number of promotoras varied by treatment assigned to the community. One community received PPN; one received PPN and OIC; one received PPN and CE and the last received PPN, OIC and CE. Outcome surveys were done at three times; baseline, during and at the end of the intervention. Data were collected at each clinic visit, and were sorted by family. Data were also collected during the surveys. Data were managed and aggregated from individual to the family and then to the community. Data were also collected on nurse and promotora activities over the course of the study. Findings: The effect of PPN and OIC on health outcomes and status were positive with statistically significant results. Although there was little difference between the ethnic groups, there was a difference between sites. Over 7,000 patients were seen during the study primarily for disease prevention and chronic illness management. Activities such as vaccinations, hypertension detection and treatment, cholesterol measurement and treatment, diabetes detection and treatment and family planning activities were conducted. The promotoras focused on case finding, advocacy and follow up. The number and types of activities support this finding. Last, the communities obtained a permanent source of nursing care for the valley. This was a positive outcome for the effect of CE. Conclusions: The experiment was a moderate success and revealed statistically significant findings in the outcome variables. Preventive services and disease screening yielded better outcomes with a greater number of the outcomes showing statistically significant differences over the course of the study. Promotoras, selected by the community were able to increase clinic use and instituted specific classes in community interest areas. The test of the Aday and Anderson model showed interesting results with some areas showing an R2 of 35%. However, the impact of certain expected variables were negligible. Implications: The design and management of this experiment was costly and time consuming. However, such projects are required if we are to learn more about the effect of nursing protocols on communities. Since more and more care is being placed in the community, the health of its members and the services they need and use are critically important. In addition, under today's fiscal restraints individuals and communities can fall through the health care safety net. The health outcomes of these communities were improved over time and preventive services were accessed. It is less costly to work with the community rather than treat individuals for the many chronic illnesses that can be prevented or caught early.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Test of a Model of Community Nursing for Rural Hispanicsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/152886-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Test of a Model of Community Nursing for Rural Hispanics</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Ferketich, Sandra, PhD, RN, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of New Mexico HSC</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Dean and Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">sferketich@salud.unm.edu</td></tr><tr><td colspan="2" class="item-abstract">This report is of the test of a Comprehensive Multilevel Nursing Practice Model For Rural Hispanics funded by the Agency on Health Care Policy and Research for five years with an additional one-year no-cost extension. Objective: The objective was to test three components of community health nursing in four rural communities on the outcomes of health status and health impact. The components were personalized preventive nursing (PPN), organized indigenous caregivers (OIC), and community empowerment (CE). Design: Four rural communities were randomly assigned (without replacement) to the four treatments in this experimental design. The assignments permitted an examination of the main and/or interaction effects over time of a) the three treatments (PPN, OIC, CE), b) ethnicity and site, c) ethnicity and outcomes of health status d) and ethnicity and health impact. Population, Sample, Setting, Years: There were approximately 10,000 residents, 50% of whom were Hispanic and 50% non-Hispanic white. All subjects were in the sample for the treatment protocols. However, the outcome measure surveys were randomly assigned to different households, with a total 1,400 households across the communities. Three surveys were done over 5 years. These communities were in sparsely populated, underserved areas of Arizona. The communities were economically depressed and highly dependent upon copper mining. The study was conducted from 1990 to 1995 with an additional year for analysis, 1995-1996. Concepts and Variables: Health care availability, accessibility, acceptability and affordability were concepts on which the treatment protocols were based. As part of the Aday and Anderson Model, the impact of these concepts through the treatments was assessed through the outcome variables of Health Status and Health Outcomes. Methods: A team of a community health nurse and promotoras (community lay caregivers) was developed for each community. The number of promotoras varied by treatment assigned to the community. One community received PPN; one received PPN and OIC; one received PPN and CE and the last received PPN, OIC and CE. Outcome surveys were done at three times; baseline, during and at the end of the intervention. Data were collected at each clinic visit, and were sorted by family. Data were also collected during the surveys. Data were managed and aggregated from individual to the family and then to the community. Data were also collected on nurse and promotora activities over the course of the study. Findings: The effect of PPN and OIC on health outcomes and status were positive with statistically significant results. Although there was little difference between the ethnic groups, there was a difference between sites. Over 7,000 patients were seen during the study primarily for disease prevention and chronic illness management. Activities such as vaccinations, hypertension detection and treatment, cholesterol measurement and treatment, diabetes detection and treatment and family planning activities were conducted. The promotoras focused on case finding, advocacy and follow up. The number and types of activities support this finding. Last, the communities obtained a permanent source of nursing care for the valley. This was a positive outcome for the effect of CE. Conclusions: The experiment was a moderate success and revealed statistically significant findings in the outcome variables. Preventive services and disease screening yielded better outcomes with a greater number of the outcomes showing statistically significant differences over the course of the study. Promotoras, selected by the community were able to increase clinic use and instituted specific classes in community interest areas. The test of the Aday and Anderson model showed interesting results with some areas showing an R2 of 35%. However, the impact of certain expected variables were negligible. Implications: The design and management of this experiment was costly and time consuming. However, such projects are required if we are to learn more about the effect of nursing protocols on communities. Since more and more care is being placed in the community, the health of its members and the services they need and use are critically important. In addition, under today's fiscal restraints individuals and communities can fall through the health care safety net. The health outcomes of these communities were improved over time and preventive services were accessed. It is less costly to work with the community rather than treat individuals for the many chronic illnesses that can be prevented or caught early.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T11:53:46Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T11:53:46Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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