Nursing Doctoral Work

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Browsing Nursing Doctoral Work by Subject "adolescent"

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    Adolescent obesity pathway: Updating clinical practice guidelines in primary care
    (North Dakota State University, 2024) Fechtner, Amanda
    Obesity has become a public health crisis with the prevalence of pediatric obesity being one in five children in the United States. The effects of the COVID-19 pandemic and widening social disparities are driving obesity rates up. Preventing obesity in children should be priority but despite our society’s best efforts, children are crossing the BMI threshold and entering an obese BMI range. Advances in medication options are showing promising results for adolescents with obesity when combined with a healthy diet and exercise. Additionally, surgical options are proving to be safe and sustainable options for children 14 years and older. Clinicians who care for adolescents have received minimal education on treatment guidelines for adolescents with severe obesity. This evidence-based practice improvement project sought to find out if providing education on assessment and treatment of obesity in adolescents and providing a sample of clinical practice guidelines to reflect the 2023 American Academy of Pediatrics practice guidelines would adequately provide knowledge to increase clinician confidence in treating adolescents with obesity. The primary goal of this project was to increase the knowledge of clinicians about effective weight loss treatments for adolescents, including bariatric surgery, increase clinician confidence in treating adolescents with obesity, and decrease weight bias barriers. An education session was presented which comprised of education on reducing weight bias perceptions, treating pediatric obesity with lifestyle changes and medications, and when to refer to bariatric surgery. Of the 40 healthcare providers that attended the education, five clinicians filled out the pre- and post-survey. The surveys included six questions asking about confidence in discussing, assessing, and treating obesity in adolescents, the Beliefs About Obese Persons tool, and three questions to assess the quality and effectiveness of the education as a whole. The education was found to increase clinician’s confidence in bringing up the subject of obesity, formulating a treatment plan, and using professional language. More education is needed to adequately educate clinicians on when an adolescent should be referred to the bariatric surgery clinic. Additionally, the education decreased the participants’ belief that an individual is solely responsible for their obesity.
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    Adolescent Sexual and Reproductive Needs in Rural ND: A Needs Assessment
    (North Dakota State University, 2020) Pomonis, Hailey Sierra
    In order to reduce sexual risk behaviors and related health problems, preventative and educational measures must be implemented to help adolescents adopt lifelong attitudes and behaviors that support their health and well-being. Given the period of adolescence is a time of increased risk, positive health practices are vital. The end goal of this quality improvement project is to help form positive health practices during the period of adolescence, this in turn will create a healthy and strong passageway into adulthood. A qualitative approach was used to elicit the perspectives of adolescents, health providers, educators, and parents regarding the sexual and reproductive health needs of adolescents in rural N.D. Individual, semi-structured interviews were conducted with five participants in each target group. It was evident in the provider interviews that there was a range of approaches to addressing sexual and reproductive health with adolescents. Their approaches ranged from very comprehensive, to more limited in the discussion of sexual and reproductive health with the adolescents they saw in their clinic. The fact that the amount and quality of information adolescents received was entirely dependent upon which individual provider they happened to see means that both consistency and quality of information was compromised. The educators described little to no experience discussing sexually education with adolescents. The only educator participant who actively educated adolescents on sexual and reproductive health was a health educator within a rural school system. The parent participants stated that adolescents need more open and honest education regarding sexual and reproductive health. The adolescent participants gave one-worded responses; they did not expound on any questions they were asked. The interviewer asked for an expansion on their one-worded answers, but the adolescents would repeat what they had said initially. The adolescent participants were asked about sexual and reproductive health messages given to them by either health care providers, educators, or parents. Their responses consisted of abstinence is best, and the consequences of sexual experimentation. If this is the adolescent participants’ truthful answer, it is concerning on many levels.
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    C.O.P.E. Influence on Resiliency and Self-Efficacy in a Rural North Dakota School (Creating Opportunities for Personal Empowerment)
    (North Dakota State University, 2021) Schwarzrock, Ariel Kristine
    One in three teens is estimated to experience an anxiety disorder between 13 to 18 years of age. Developed mental health burdens in adolescents can go undetected and untreated. About 50% of those with mental health disorders noted in adulthood started by age 14 years. Therefore, adolescence may be a critical phase for developing positive coping mechanisms and one where nurse practitioners can proactively impact outcomes. Cognitive behavioral therapy (CBT) is an evidence-based strategy effective in decreasing mental health burden. Creating Opportunities for Personal Empowerment (COPE) is a program created for pediatrics using CBT strategies to manage emotions and promote healthy lifestyles. The purpose of the practice improvement project (PIP) was to improve resiliency and self-efficacy in junior high students at a rural North Dakota (ND) junior high school through COPE program implementation. Objectives included assessing if adolescent resilience and self-efficacy scores increased after implementation of the program with evaluation to make recommendations based on literature findings and project outcomes. The Integrated Theory of Health Behavior Change (ITHBC) helped guide the PIP and suggests adolescents can be taught to engage in healthy behaviors for effective mental health management through healthy coping skills and behaviors. A logic model helped guide and evaluate the program. The school counselor in a rural ND school became certified in COPE to facilitate and identified five students willing to participate. The COPE Teen seven-session program was implemented with parental consent and IRB approval; each session lasted approximately 30 to 45 minutes weekly in the school. Qualitative and quantitative data were collected via paper pre- and post- surveys for evaluation. Descriptive statistics were used to evaluate objectives. All data collected was entered and stored online in a Qualtrics database to aide security and statistical analyzation. Despite implementation during the COVID-19 pandemic, overall resiliency and self-efficacy scores increased for students after implementation. Students indicated they enjoyed the program and identified learned skills to be beneficial. The COPE program was recommended to continue in the school with further research and larger sample sizes to support proactive approaches to mitigate adolescent mental health care between the NP and school settings.