Date of Graduation

Fall 12-16-2023

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

Program

Population Health Leadership

First Advisor

Juli C. Maxworthy

Second Advisor

Jo Loomis

Abstract

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive health care is not addressed with culturally appropriate interventions, obesity, diabetes, hypertension, and depression comorbid conditions will escalate with the expanding Latinx population growth (Brown et al., 2018; Creech et al., 2019; Oh & Ell, 2018; Silverman et al., 2018).

Methods: This Doctor of Nursing Practice student-led quality improvement project was part of a group educational project to teach community health workers, among other topics, about chronic disease prevention. Pre- and post-assessment surveys and curricula were created and distributed to all community health worker (CHW; students) participants of the local community organization collaboration. Educational material and screening forms were adapted to culturally appropriate English and Spanish formats (Amerson et al., 2015; Frank et al., 2021; Harris et al., 2021). Collaborative DNP student participants collected demographic data. Redundancy was avoided.

Interventions: The CHWs were instructed through two synchronous and one in-person educational modules. Screening tools and chronic disease educational handouts were provided to each CHW via eHealth attachments within the online modules, aids for enriching client experiences during home visits. Bilingual symptom guides incorporated into each module allowed for role-addition health assessments by the CHWs, utilizing new knowledge of chronic disease, risks, and prevention strategies. Enhanced self-confidence since completing all components affords improved screenings, evaluations, referrals, and patient education. The educational experience was conducted in the Spring of 2023.

Results: The three main objectives were: (a) CHWs would have a 25% increase in knowledge of non-communicable chronic diseases for adults (diabetes, depression, obesity, and hypertension) and utilization of culturally appropriate screening tools by June 2023. A pre-assessment/post-assessment survey conducted in English was the measuring tool; (b) by June 2023, 75% of the CHWs would express a 25% improvement in confidence to integrate health assessments and utilize screening tools in their roles with adult Latinx populations; (c) by June 2023, 75% of the CHWs would appraise their confidence had increased by 25% to qualify for the USFCA SONHP Promotora certificate of participation. The goal was to teach to the level of CHW or Promotora.

Conclusions: Training CHWs on a role addition for health using culturally tailored, humble, evidence-based strategies to promote positive health behaviors will improve this population's mental and physical health (STC, 2021). The partner collaboration with the USF SONHP DNP program is steeped within best practice recommendations (Melnyk & Fineout-Overholt, 2018).

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