Theses and Dissertations at Montana State University (MSU)
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Item Human trafficking: what is the role of the healthcare professional?(Montana State University - Bozeman, College of Nursing, 2018) Jennings, Melissa Rae; Chairperson, Graduate Committee: Alice RunningThe idea of this professional project originated after a learning-needs assessment was performed by the education department on the Labor and Delivery/Mother Newborn unit at a healthcare facility in Montana. Information obtained from the learning-needs assessment indicated that the staff wanted more information on human trafficking in the healthcare setting. A literature review was completed regarding human trafficking in the healthcare setting and the evidence showed that healthcare professionals are not adequately trained in identification of a human-trafficking victim, rescuing a victim, or resource utilization for suspected victims. An educational presentation was developed and learning objectives were identified. The goal of the project was to increase staff awareness regarding human-trafficking victims, increase confidence in the ability to identify a trafficked victim, and provide staff with resources in the event that they encounter a human-trafficking victim. A pretest to assess knowledge of the topic was given immediately prior to the presentation and a posttest was given immediately after the presentation to assess attainment of learning objectives. Results showed an increased awareness of this topic post presentation and staff felt more confident in identifying a human-trafficking victim. Staff were given resources to utilize at the end of the presentation to assist them in identifying potential victims and use for referral purposes on their unit. Although this was one area to increase awareness of the problem of human trafficking, there continues to be a need for protocol development for healthcare providers, collaboration amongst law enforcement, service providers, and private organizations and increased research regarding this topic.Item Breaking the cycle of adverse childhood experiences: a program evaluation(Montana State University - Bozeman, College of Nursing, 2019) McAnally, Jennifer Lyles; Chairperson, Graduate Committee: Dale MayerAdverse childhood experiences (ACEs) are specific types of childhood trauma, that, when experienced, have been found to have dose-response relationship to poor health outcomes later in life, namely, many of the leading causes of death in adults. ACEs include psychological, physical, or sexual abuse, witnessing violence against the mother, living with household members who were substance abusers, mentally ill or suicidal, or who are imprisoned. Recognizing a need for intervention to disrupt this ACE to illness trajectory, The American Academy of Pediatrics has called upon medical providers to address ACEs through screening and community-building. Since there is currently no guideline for how to address ACEs, the purpose of this scholarly project was to evaluate the Lewis and Clark County Health Department (L&CHD) ACE program for effectiveness and alignment with evidence-based practice. Using the Centers for Disease Control and Prevention manual titled Introduction to Program Evaluation for Public Health Programs (IPEPHP), an evaluation was completed. Steps included engaging stakeholders, describing the program, developing an evaluation plan, gathering credible evidence, and analyzing the evidence in order to develop conclusions and make recommendations. The L&CHD ACE program was found to be a largely progressive model that is consistent with most program goals and literature. Those who participated in the program tended to complete the program successfully, however, a majority of those who were referred to the ACE program either chose not to take advantage of the referral or declined to participate in the program. This finding was unexpected and warrants further inquiry. It appears that an integrated behavioral health model may be more effective for engaging potential participants, where they are able to initially meet with mental and behavioral health experts in the familiar primary care setting.Item Interventions for the prevention of opiate use disorder in patients with high adverse childhood experience scores in northern New Mexico: a qualitative project(Montana State University - Bozeman, College of Nursing, 2019) Clawson, Kendra Sweeney; Chairperson, Graduate Committee: Maria WinesAdverse childhood experiences (ACEs) are known to be associated with chronic disease, various disorders, and social-emotional challenges (Anda et al., 2008). Furthermore, illicit drug use has been indicated to be associated with ACE scores, in a dose-dependent relationship (Centers for Disease Control and Prevention, 2016a). This DNP project explored the experience of patients with opiate use disorder (OUD) in northern New Mexico, who had ACE scores of four or greater. The purpose of the project was to identify, via structured interviews, interventions the participants felt may have been significant in preventing their OUD. The project sought to specifically examine interventions as they relate to ACEs. The project gave a voice to those who have the lived experience of both ACEs and OUD, to synthesize strategies to address ACEs, and conceivably build resilience. In analyzing the participant responses, the most prominent themes identified were intentional communication, understanding the home environment, creating a safe space for the pediatric patient, referring to counseling, and providing increased education regarding opiates and mental health respectively. These approaches were compared to similar interventions in the literature, to synthesize recommendations to inform the practice of primary care providers, school nurses, and counselors who interact with children with high ACE scores in the northern New Mexico region (Felitti et al., 1998).