Step Into Wellness: A Nurse Practitioner-Directed Interprofessional Intervention for Underserved Populations

2.50
Hdl Handle:
http://hdl.handle.net/10755/621564
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Step Into Wellness: A Nurse Practitioner-Directed Interprofessional Intervention for Underserved Populations
Other Titles:
Global Interprofessional Health Promotion
Author(s):
Rouen, Patricia A.; Baiardi, Janet M.
Lead Author STTI Affiliation:
Rho
Author Details:
Patricia A. Rouen, PhD, FNP-BC, Professional Experience: Dr. Patricia Rouen has over 35 years of nursing experience with 20 years as family nurse practitioner in primary care with the past 10 years working with vulnerable populations in an urban environment. Dr Rouen is an associate professor of nursing in the McAuley School of Nursing since 1999 at the University of Detroit Mercy in Detroit, MI, USA. She teaches in both the Family Nurse Practitioner and Doctor of Nursing Practice program. Author Summary: Dr. Patricia Rouen has 35 years of nursing experience with 20 years as a family nurse practitioner. She is faculty in the McAuley School of Nursing at the University of Detroit Mercy in Detroit, MI, USA. She teaches in the graduate nursing programs. Her research and practice interests address women's health, vulnerable populations, nutrition, menopause and diabetes.
Abstract:

Purpose:

In the United States (U.S.), national data demonstrate high mortality rates and poor health outcomes from chronic diseases among persons without insurance or fragmented access to healthcare (Bittoni, Wexler, Spees, Clinton & Taylor, 2015). The era of accountable care emphasizes health promotion and new strategies to build capacity for equitable population-focused care in the primary care and community health setting (Edmonds, Campbell & Gilder, 2016). A key principle in patient engagement for health includes a sense of belonging and authentic participation that is associated with better outcomes and quality of life (Porter, Pabo, & Lee, 2013). A growing body of evidence documents that culturally relevant community-based nutrition education (Ball, McNaugton, Le, Abbott, Stephens, & Crawford, 2016; Ko, Rodriguez, Yoon, Ravindran & Copeland, 2016) and physical activity programs (Conn, Chan, Banks, Ruppar & Scharff, 2014) are effective strategies in low income populations. Emerging data also show that social media strategies, such as text messaging, support successful health outcomes (Head, Noar, Iannarino & Harrington, 2013). As health advocates, nurse practitioners (NPs) are providers grounded in health promotion, system thinking and community-based care that are well-positioned to implement culturally-relevant health promotion interventions to the underserved communities and patients they serve. Purpose: Guided by the social-ecological framework, the purpose of this project was to initiate nurse practitioner-led interventions to support accountable care and improve nutrition and physical activity health outcomes in a diverse underserved population receiving care in an urban free primary care clinic.

Methods:

We used a multi-level approach to engage the populations receiving care at the clinic along with the administrative and clinical staff, and established partnerships with community-based organizations to support the planned health interventions. A quasi-experimental pretest-posttest study design was used. We enrolled three cohorts of diverse participants (ages 19-64 years) in a 13 week program: seven weeks of nutrition education/cooking classes that included a curriculum customized to the clinic population and six weeks of physical activity (gentle yoga, pedometer-guided walking programs). The groups met weekly for two hours. Ethnically diverse professionals: registered dietitians, a professional chef and yoga instructor supported the program. The nurse practitioners sent weekly text messages that were either spiritual or motivational in nature to reinforce the program content. System-level interventions included implementing participant identification cards and patient satisfaction surveys revisions. Clinical outcomes included nutrition knowledge, perceived stress, steps walked, blood pressure, and body mass index (BMI). System level outcomes addressed program evaluation and patient satisfaction. Data were analyzed with descriptive statistics and paired t-tests.

Results:

The 42 participants were primarily female (81%; N=34) with eight men and included blacks (76%), Hispanics (14%) and whites (10%). Three patients were homeless. Participant were on average 50 years old and obese (mean BMI: 31.6 kg/m2). Nutrition knowledge improved from baseline (58.6+13.7 vs. 83.5+14.0; p<0.001) as did steps walked (4448.6 + 2719 vs. 7564.6 + 4151.1; p=0.03). Systolic and diastolic blood pressure values did decline as did BMI but did not achieve significance. Perceived stress levels were unchanged. Program satisfaction data was positive. Participants reported the yoga relieved muscle aches and pains, they felt cared for and were pleased and relieved to have identification cards. The community agencies and the clinic were able to secure ongoing partnership agreements.

Conclusion:

Nurse Practitioners are well-positioned to organize and implement culturally-relevant and evidence-based patient and system level innovations in community settings that are customized to promote health outcomes among the uninsured and underserved.

Keywords:
Health Intervention; Nurse Practitioners; Underserved Populations
Repository Posting Date:
21-Jun-2017
Date of Publication:
21-Jun-2017
Other Identifiers:
INRC17B07
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleStep Into Wellness: A Nurse Practitioner-Directed Interprofessional Intervention for Underserved Populationsen_US
dc.title.alternativeGlobal Interprofessional Health Promotionen
dc.contributor.authorRouen, Patricia A.en
dc.contributor.authorBaiardi, Janet M.en
dc.contributor.departmentRhoen
dc.author.detailsPatricia A. Rouen, PhD, FNP-BC, Professional Experience: Dr. Patricia Rouen has over 35 years of nursing experience with 20 years as family nurse practitioner in primary care with the past 10 years working with vulnerable populations in an urban environment. Dr Rouen is an associate professor of nursing in the McAuley School of Nursing since 1999 at the University of Detroit Mercy in Detroit, MI, USA. She teaches in both the Family Nurse Practitioner and Doctor of Nursing Practice program. Author Summary: Dr. Patricia Rouen has 35 years of nursing experience with 20 years as a family nurse practitioner. She is faculty in the McAuley School of Nursing at the University of Detroit Mercy in Detroit, MI, USA. She teaches in the graduate nursing programs. Her research and practice interests address women's health, vulnerable populations, nutrition, menopause and diabetes.en
dc.identifier.urihttp://hdl.handle.net/10755/621564-
dc.description.abstract<p><strong>Purpose:</strong></p> <p>In the United States (U.S.), national data demonstrate high mortality rates and poor health outcomes from chronic diseases among persons without insurance or fragmented access to healthcare (Bittoni, Wexler, Spees, Clinton & Taylor, 2015). The era of accountable care emphasizes health promotion and new strategies to build capacity for equitable population-focused care in the primary care and community health setting (Edmonds, Campbell & Gilder, 2016). A key principle in patient engagement for health includes a sense of belonging and authentic participation that is associated with better outcomes and quality of life (Porter, Pabo, & Lee, 2013). A growing body of evidence documents that culturally relevant community-based nutrition education (Ball, McNaugton, Le, Abbott, Stephens, & Crawford, 2016; Ko, Rodriguez, Yoon, Ravindran & Copeland, 2016) and physical activity programs (Conn, Chan, Banks, Ruppar & Scharff, 2014) are effective strategies in low income populations. Emerging data also show that social media strategies, such as text messaging, support successful health outcomes (Head, Noar, Iannarino & Harrington, 2013). As health advocates, nurse practitioners (NPs) are providers grounded in health promotion, system thinking and community-based care that are well-positioned to implement culturally-relevant health promotion interventions to the underserved communities and patients they serve. <strong>Purpose</strong>: Guided by the social-ecological framework, the purpose of this project was to initiate nurse practitioner-led interventions to support accountable care and improve nutrition and physical activity health outcomes in a diverse underserved population receiving care in an urban free primary care clinic.</p> <p><strong>Methods:</strong></p> <p>We used a multi-level approach to engage the populations receiving care at the clinic along with the administrative and clinical staff, and established partnerships with community-based organizations to support the planned health interventions. A quasi-experimental pretest-posttest study design was used. We enrolled three cohorts of diverse participants (ages 19-64 years) in a 13 week program: seven weeks of nutrition education/cooking classes that included a curriculum customized to the clinic population and six weeks of physical activity (gentle yoga, pedometer-guided walking programs). The groups met weekly for two hours. Ethnically diverse professionals: registered dietitians, a professional chef and yoga instructor supported the program. The nurse practitioners sent weekly text messages that were either spiritual or motivational in nature to reinforce the program content. System-level interventions included implementing participant identification cards and patient satisfaction surveys revisions. Clinical outcomes included nutrition knowledge, perceived stress, steps walked, blood pressure, and body mass index (BMI). System level outcomes addressed program evaluation and patient satisfaction. Data were analyzed with descriptive statistics and paired t-tests.</p> <p><strong>Results:</strong></p> <p>The 42 participants were primarily female (81%; N=34) with eight men and included blacks (76%), Hispanics (14%) and whites (10%). Three patients were homeless. Participant were on average 50 years old and obese (mean BMI: 31.6 kg/m2). Nutrition knowledge improved from baseline (58.6+13.7 vs. 83.5+14.0; p<0.001) as did steps walked (4448.6 + 2719 vs. 7564.6 + 4151.1; p=0.03). Systolic and diastolic blood pressure values did decline as did BMI but did not achieve significance. Perceived stress levels were unchanged. Program satisfaction data was positive. Participants reported the yoga relieved muscle aches and pains, they felt cared for and were pleased and relieved to have identification cards. The community agencies and the clinic were able to secure ongoing partnership agreements.</p> <p><strong>Conclusion:</strong></p> <p>Nurse Practitioners are well-positioned to organize and implement culturally-relevant and evidence-based patient and system level innovations in community settings that are customized to promote health outcomes among the uninsured and underserved.</p>en
dc.subjectHealth Interventionen
dc.subjectNurse Practitionersen
dc.subjectUnderserved Populationsen
dc.date.available2017-06-21T13:42:24Z-
dc.date.issued2017-06-21-
dc.date.accessioned2017-06-21T13:42:24Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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