ABSTRACT
OBJECTIVE: The Peer Engaged Empowered Recovery (PEER) program is a county collaboration between specialty behavioral health and probation departments to address substance use and related problems by providing team-based peer recovery specialist (PRS) services. The study aimed to assess the feasibility and potential effectiveness of PEER and propose recommendations. METHOD: Eligible clients released from jail had suspected substance use disorder and were assigned to the local drug court, on pretrial probation, or considered of high risk of recidivism. Clients were offered PRS support for 6 months. Client-reported data, administrative data on services, and survey data from program stakeholders were assessed. RESULT: The program successfully identified clients with substance use disorder who had high to very high levels of need for social determinants of health, comorbid mental illness and other chronic conditions, and a high recidivism risk. Clients were served predominantly by phone despite complex needs. The sustainability of the PEER program was rated as stable along many dimensions except funding stability. CONCLUSION: The PEER pilot program was well targeted. The average level of health and social need among clients was high, and many were difficult for PRS to contact. PRS services, which are currently undifferentiated in the state, may need to be risk-stratified in the future to take into account health and social factors and to align caseloads, reimbursement, and training.
Subject(s)
Prisoners , Substance-Related Disorders , Feasibility Studies , Humans , Jails , Peer GroupABSTRACT
BACKGROUND: In response to the COVID-19 pandemic, many health care organizations have adopted telehealth. The current literature on transitioning to telehealth has mostly been from large health care or specialty care organizations, with limited data from safety net or community clinics. OBJECTIVE: This is a case report on the rapid implementation of a telehealth hub at an academic nurse-managed community clinic in response to the national COVID-19 emergency. We also identify factors of success and challenges associated with the transition to telehealth. METHODS: This study was conducted at the George Mason University Mason and Partners clinic, which serves the dual mission of caring for community clinic patients and providing health professional education. We interviewed the leadership team of Mason and Partners clinics and summarized our findings. RESULTS: Mason and Partners clinics reacted quickly to the COVID-19 crisis and transitioned to telehealth within 2 weeks of the statewide lockdown. Protocols were developed for a coordination hub, a main patient triage and appointment telephone line, a step-by-step flowchart of clinical procedure, and a team structure with clearly defined work roles and backups. The clinics were able to maintain most of its clinical service and health education functions while adapting to new clinic duties that arose during the pandemic. CONCLUSIONS: The experiences learned from the Mason and Partners clinics are transferable to other safety net clinics and academic nurse-led community clinics. The changes arising from the pandemic have resulted in sustainable procedures, and these changes will have a long-term impact on health care delivery and training.
ABSTRACT
Uninsured Latin American immigrant women are at increased risk for vaccine preventable diseases, such as cervical cancer; yet gaps in vaccine coverage persist. The purpose of this study was to explore vaccine-related knowledge, attitudes and decision-making for tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, meningococcal conjugate vaccine (MenACWY), and human papillomavirus (HPV) vaccine among uninsured Latin American immigrant mothers of adolescent daughters. A purposive sample of 30 low-income, uninsured, predominantly Latin-American immigrant mothers of adolescent daughters aged 13-17 were recruited from two academic-community managed health clinics in Virginia. From March-September 2016, data were collected through in-person, semi-structured interviews, in English or Spanish. For data analysis, conventional content analysis was employed. The majority of participants self-identified as Hispanic and had less than a high-school level education. Key themes included: general acceptance of vaccines; associating vaccines with prevention/protection; minimal vaccine hesitancy; and lack of knowledge regarding vaccine-preventable diseases, vaccines recommended for adolescents, and adolescent daughters' vaccination history. Doctors' recommendation, school requirements, and the media were key influencers of vaccination. Mothers were the primary decision-maker regarding vaccine uptake among their adolescent daughters. Findings highlight the need for efforts to help uninsured Latin American immigrant mothers better understand vaccines, and provide linkages to affordable, accessible vaccines among under-resourced populations.
Subject(s)
Decision Making , Emigrants and Immigrants/psychology , Health Knowledge, Attitudes, Practice/ethnology , Medically Uninsured/psychology , Mothers/psychology , Vaccination/psychology , Adolescent , Adult , Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage , Female , Hispanic or Latino/psychology , Humans , Medically Uninsured/ethnology , Meningococcal Vaccines/administration & dosage , Middle Aged , Nuclear Family , Papillomavirus Vaccines/administration & dosage , Patient Acceptance of Health Care , Poverty , Qualitative Research , Vaccines, Conjugate/administration & dosage , VirginiaABSTRACT
: Proper nutrition is an important but often overlooked component of preventive care and disease management. Following a plant-based diet in particular has been shown to have dramatic effects on health and well-being in a relatively short period of time. For this reason, nurses at three faculty-led community health clinics participated in a nutrition educational program, following a plant-based diet for 21 days. They sought to improve their knowledge of plant-based nutrition and experience firsthand the benefits of such a diet. The authors conclude that this type of program, with its experiential component and beneficial personal health results, has the potential to influence a larger nursing audience as participants apply their knowledge and experience to patient care and to classroom discussions with nursing students.
Subject(s)
Diet , Nurse-Patient Relations , Patient Education as Topic/methods , Plants , Health Promotion , Humans , United StatesSubject(s)
Aged , Evidence-Based Medicine/organization & administration , Geriatric Nursing/organization & administration , Practice Guidelines as Topic , Spirituality , Terminal Care/organization & administration , Adaptation, Psychological , Aged/psychology , Anxiety/prevention & control , Depression/psychology , Geriatric Assessment , Health Promotion , Humans , Loneliness/psychology , Morale , Nurse's Role/psychology , Nurse-Patient Relations , Nursing Assessment , Risk Factors , Social Isolation , Social Support , Stress, Psychological/prevention & control , Terminal Care/psychologyABSTRACT
Collaboration provides a unique opportunity for a variety of people and organizations to promote faith community nursing. With emphasis on holistic nursing, stewardship, and interpreting the dialogue between faith and health, educated nurses acting as health educators, planners, and counselors can aid in meeting the health needs and in promoting the well-being of their faith communities.
