College of Letters & Science
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The College of Letters and Science, the largest center for learning, teaching and research at Montana State University, offers students an excellent liberal arts and sciences education in nearly 50 majors, 25 minors and over 25 graduate degrees within the four areas of the humanities, natural sciences, mathematics and social sciences.
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Item Community-based prevention education on abusive head trauma in a Montana Native American community(Montana State University - Bozeman, College of Nursing, 2019) Schmitt, Emily Marie; Chairperson, Graduate Committee: Sandra KuntzThis scholarly project cultivated a partnership with a Montana Native American community to develop an implementation method of an evidence-based, abusive-head-trauma-prevention education program. The partnering community felt that more could be done to prevent abusive head trauma. Utilizing the framework of Community-Based Participatory Research and the Rural Nursing Theory, this project identified the best available evidence and then developed multiple methods to implement this prevention material. Multiple lessons were learned and important reflections developed from the project process. These lessons can be utilized to guide future projects. A model for program implementation was developed for future use and implementation of the evidence-based, abusive-head-trauma-prevention program.Item Community assessment of cancer screening services for women in Cascade County and perceptions of American Indian women regarding those services(Montana State University - Bozeman, College of Nursing, 2001) Rowell, Nancy Jo; Chairperson, Graduate Committee: Therese SullivanItem Implementing an oral health tool and motivation interviewing tool to improve oral health care among type II diabetics on a northern plains reservation(Montana State University - Bozeman, College of Nursing, 2016) Show, Jennifer Aurice; Chairperson, Graduate Committee: Elizabeth S. KinionType II diabetes and periodontal disease are two common chronic diseases that have been shown to have a physiologically bi-directional relationship. In recent years, type II diabetes and periodontal disease have reached epidemic proportions throughout the United States; disproportionately affecting racial and ethnic minorities such as American Indians. American Indians often have diabetes rates that are two times the general U.S. population and periodontal disease rates that are equally as high. Adding to the oral health disparity in American Indian populations, accessing dental care is often limited making oral health preventive behaviors especially important. This project chose to examine oral health in a group of American Indian adults with type II diabetes focusing on 1) the identification of oral health status using the Oral Health Assessment Tool 2) the facilitation of oral health care to the local Indian Health Service agency and 3) supporting and improving preventive oral health behaviors through motivational interviewing. Participants took part in bi-weekly face-to-face motivational interviewing sessions with their oral health status being evaluated using the Oral Health Assessment Tool concurrently. Participants were referred to the local Indian Health Service agency for dental care based on Oral Health Assessment scores. Scores could range from 0 (good oral health) to 16 (poor oral health). The overall analysis of data found a slight improvement in average Oral Health Assessment Tool scores from 2.75 at baseline to 2.25 at three months. Content analysis of the motivational interviewing sessions found an increased interest among participants to improve oral health behaviors such as brushing for longer periods of time or a desire to quit smoking. The findings of this study are encouraging. While the Oral Health Assessment Tool scores did not improve by leaps and bounds, it does show promise for the use of motivational interviewing to improve preventive oral health behaviors in the American Indian population while also showing the ease of integrating the Oral Health Assessment Tool into general diabetes care.Item Oral health outreach and education in a non-dental, American Indian setting(Montana State University - Bozeman, College of Nursing, 2016) Taubert, Kate Lisco; Chairperson, Graduate Committee: Laura LarssonTooth decay is the single most common chronic childhood disease (Centers for Disease Control and Prevention, 2014) and children with minority and low socioeconomic status are at an increased risk for early childhood caries (ECC) development. The number of children who routinely visit primary care providers is much higher than those who have seen a dental provider (American Academy of Pediatrics, 2008). Thus, pediatric primary care providers are in an opportune position to provide oral health screenings, interventions, and referrals. The purpose of this quality improvement project was to identify, implement, and evaluate a Doctor of Nursing Practice (DNP) pediatric oral health outreach and education quality improvement project in an American Indian, pediatric primary care setting. The intervention contained three parts including a caries risk assessment, caregiver education, and a same-day dental home referral. All caregiver/child dyads age birth - 5 years presenting to the pediatric clinic for a well-child visit were eligible and consented to the intervention (n = 47). The results determined that 86.84% of the sample population was at high risk for caries development and that 52.78% of children with first tooth eruption had previously seen a dentist. Of those children, 78.95% had caries. For children with first tooth eruption that had not seen a dental provider in the past three months, a successful completed referral rate of 72.41% was obtained. The average intervention duration was 4.73 minutes. The intervention was successful in integrating well-child and well-dental visiting into a combined visit that was feasible to sustain. All caregiver/child dyads consented to the intervention and received age appropriate oral health education. This interprofessional collaboration and was effective in addressing three aspects of oral health prevention and outreach. Oral health is part of total health, and thus should be incorporated into routine well-child visits.Item Heights and weights of Northern Cheyenne children : comparison to the international growth reference(Montana State University - Bozeman, College of Nursing, 1992) Dodson, Mary MargaretItem Factors contributing to emergency department utilization in a rural Indian Health Service hospital(Montana State University - Bozeman, College of Nursing, 1984) Magee, CherylItem Binge eating and bulimic behaviors in a select Native American adolescent population(Montana State University - Bozeman, College of Nursing, 1993) Auker, Luana MaeItem Practice implications for addressing Native American youth suicide : an integrative review(Montana State University - Bozeman, College of Nursing, 2013) Erickson, Janet Leigh; Chairperson, Graduate Committee: Patricia A. HolkupAmerican Indian/Alaska Natives experience the highest rate of suicide compared to all ethnic groups in the United States, and the youth of this minority population account for 40 percent these suicides. The aim of this integrative literature review was to provide information and direction to health care professionals, including nurses, who deliver care to the AI/AN youth across Indian Country. An integrative review, including a comprehensive computer-assisted search of three separate databases, and a subsequent review of the reference lists of selected articles was completed. Forty-one articles met the inclusion/ exclusion criteria. The findings, recommendations and practice implications were documented in a chart (Appendix C) and then organized according to the biological systems theory model (Appendix D), which allowed for illustration of the multi-layered risk unique to Native youth, the importance of considering the social context in which Native youth suicide occurs, and assisted in identifying practice implications specific to Native American youth. The risk factors ranged from individual and family "day-to-day realities," to factors that were a part of the adolescent's environment but not necessarily a direct influence, to cultural, economic and political issues, and historical events that remain active as factors affecting the lives of Native youth. The results of this integrative literature review provided the evidence for the need to develop a collaborative approach that is culturally anchored in the world of the Native youth. The need for increased research related to addressing the Native American youth suicide crisis is described as imperative with suggestions to focus on studying current culturally appropriate, holistic care in attempts to determine its effectiveness.Item Cultural considerations at the end of life : communication of helathcare providers with Native American patients(Montana State University - Bozeman, College of Nursing, 2012) Hunsucker, Heidi Lynn; Chairperson, Graduate Committee: Yoshiko Yamashita ColcloughThe purpose of this project was to provide information to non-Native-American healthcare providers to help enhance their communication with Native-American patients at the end of life. The end of life can be a distressing time for patients, families, and healthcare providers alike. Cultural differences which may exist among these groups can make the transition even more difficult. Communication may be hindered due to misunderstandings or unclear expectations. This project was an extension of a study focusing on an Indian reservation in north central Montana which identified several areas to focus on for improving end-of-life care including educating the patients and families about palliative care options, helping healthcare providers become more culturally sensitive, and creating a culturally appropriate and sensitive end-of-life program. A pamphlet was developed based on the findings of a literature review and information from a cultural expert to help healthcare providers identify and address communication issues at the end of life. The pamphlet addressed communication issues between non-Native-American healthcare providers and Native-American patients. Madeleine Leininger's Theory of Culture Care Diversity and Universality was used to guide the project, and a modified Delphi method was used to help create a culturally appropriate pamphlet for non-Native-American healthcare providers. By understanding their own cultural influences and taking the time to understand and respect the cultural influences of their patients, healthcare providers can provide quality end-of-life care. Communication at the end of life can be enhanced by recognizing that culture may confound understandings and expectations, and addressing that factor can help remove barriers from quality care. This pamphlet will serve as a device to help prepare APNs for the barriers they may encounter when working with patients from not only the individual tribe in north central Montana, but also to make them aware of the fact that cultural barriers exist among different cultures. Perhaps making APNs aware of the cultural differences will open the way for increasing research about different cultures in the future. APNs should enter into every patient encounter with the knowledge that there are things they can learn from their patient to better provide effective care.Item Prenatal interventions that improve Native American pregnancy outcomes and reduce infant mortality : an integrative review(Montana State University - Bozeman, College of Nursing, 2012) Bloom, Jeanne Kathryn; Chairperson, Graduate Committee: Sandra KuntzNative mothers are at increased risk for negative pregnancy outcomes and within the first year of life, Native babies have substantially higher infant mortality rates than their White counterparts. The primary aim of this study was to identify a broad range of interventions/perspectives that positively affect pregnancy outcomes and reduce infant mortality in Indigenous communities. An integrative review using four databases was conducted. Thirty-four articles met the inclusion/exclusion criteria. The findings and recommendations of each article were documented in a chart (Appendix C) that gave rise to the development of a socioecological framework for pregnancy outcomes in Native women (Appendix D). Individual factors that influence pregnancy outcomes included behaviors/lifestyles, mental health, tobacco use, educational attainment, maternal age, prenatal care, breastfeeding, immunizations, family planning, and socioeconomics/WIC enrollment. Interpersonal factors included significant other, family support, peer support, and traditional beliefs. Community factors included: community health clinics, prenatal services, SIDS education, infant care education, home visits, smoking cessation & prevention programs, injury rates/environmental safety, tribal commitment to mothers and infants, and integration of traditional and western medicine. Public policy factors included WIC, safe water and sanitation, IHS funding, and systems to monitor Native health. In total, the synthesis of the findings from the literature appears to influence pregnancy outcomes. For Native American pregnancy outcomes to improve and infant mortality rates decline, interventions will need to target all levels of the socioecological framework: individual, interpersonal, community, and public policy. In addition, Maslow's Hierarchy of Needs must be considered.