Change Master Projects Class of 2008

Delaying Experimentation with Tobacco, Alcohol, and other Drugs and Building Resilience in Middle School Children

Prepared by: Jim Thaxton; Jennifer Bell, BS, RS; Jessica Robinson, BSW; Debbie Bell, RD, LD
Mentor: Karen Hunter, MPH, RD, LD, CHES

Full Report (pdf format)

Why is drug use initiation continuing and/or increasing in youth, at younger ages, in the presence of so many drug abuse prevention programs? Our Change Master Project team set out to answer this very question. We found out early on, there was little hope of finding a single program that would prevent substance abuse and experimentation in ALL middle school students. At this point we determined there were differences. These differences involved: types of substances used and abused varied from one region to the next dependent upon their populations and urban vs. rural settings.

In order to avoid recreating the wheel, our team decided to take a look at what drug abuse prevention programs were currently available and were being used successfully. This goal developed into a tool that would assist agencies in identifying those curriculums that are evidence-based and work for specific drugs and populations.

The website SAMHSA (Substance Abuse and Mental Health Services Administration) was a tremendous resource in helping us connect populations and programs. In addition, we felt in necessary to look at existing programs in Kentucky that were successful and the key players that were involved in presenting these programs. We surveyed Health Department Directors, Regional Prevention Center Coordinators, and Kentucky Agencies for Substance Abuse Policy to determine the level of partnerships and collaboration, programs they found to be effective and programs they identified as ineffective.

Serendipitously, while putting this together NPR (National Public Radio) did a program on “Cheez” which highlighted the very substance from which we derived our team name. This expose addressed the addition of a 9 year old girl. Once again validating the relevance of our team project.

Death Registration Made Easy: Death Registration TRAIN Module for Physicians and Their Office Staff

Prepared by: Denise Bingham, RN, BSN; Elizabeth Crigler, BS; Dori Livy, RN, BSN; Betsy L. McDowell, RN, ARNP; Michelle Mitchell, RN, BSN; Melody L. Stafford, RN; Margie G. Hill, AAS, BA
Mentor: Randy Gooch, BS

Full Report (pdf format)

The challenge of preparing the “Death Registration Made Easy” online module began in the spring of 2007. The Vibrant Vitals KPHLI group was formed and we accepted Dr. William Hacker’s, Commissioner for the Department for Public Health, request to prepare a training module to be used by physicians and their office staff across the great Commonwealth of Kentucky when completing death certificates as required by KRS 213.076, 213.078, 213.086 and 213.091.

Death certificates are received in the Kentucky Office of Vital Statistics on a daily basis with inaccurate and incomplete information. The death certificate then has to be returned to the physician’s office to be completed accurately, which in turn results in a delay for families in getting a complete certificate. This can cause even longer delays in the receipt of Life insurance monies, Social Security benefits and estate settlements.

The online module for the Commonwealth of Kentucky and US Standard is now complete and accessible nationally on TRAIN. All licensed physicians in Kentucky will be notified of this new course offering through the Kentucky Medical Association and Kentucky Office of Vital Statistics.

Implementing National Public Health Performance Standards in Kentucky’s Local Public Health Systems
2008 Balderson Leadership Project Award Winner

Prepared by: Louise A. Kent, MBA; Deborah A. Muench, BS; Chastity Smoot, BA
Mentor: Georgia Heise, DrPH

Full Report (pdf format)

Even though there have been opportunities since 1991 to help health departments improve the quality of their services, few Kentucky health departments have implemented continuous quality improvement strategies or incorporated the available performance improvement tools into their systems. The goal of the Kentucky Public Health Leadership Institute’s (KPHLI) “Unbridled for Excellence” team was to demonstrate the functionality of the National Public Health Performance Standards Program (NPHPSP) to various local health departments in order to assist them in beginning quality improvement processes, which will be a requirement for accreditation in the coming years.

In pursuing its objective, “Unbridled for Excellence” was able to accomplish the following actions in the nine-month project timeframe. The team was able to obtain NACCHO grant funds, provide a NPHPSP kickoff training, create information and linkage resources for local health departments, provide facilitator toolkits and training, maintain monthly conference calls, provide technical support, provide funding information, and obtain graduate student resources for the local public health departments.

As of this point in time, five public health departments in KY have begun using the NPHPSP as an integral tool to strengthen public health in their region. In addition, a number of other health departments are now interested in doing the performance standards. Consequently, “Unbridled for Excellence” spearheaded the first statewide push to use NPHPSP to implement continuous quality improvement in Kentucky’s local health departments.

Colon Cancer – Motivating At Risk Kentuckians to Screening
2008 Balderson Leadership Project Award Winner

Prepared by: Jessica DuMaurier, MPH, CHES; Angela Champion, MPA; Irene Centers, BA; Amy L. Young
Mentor: Jennifer Redmond, MPH

Full Report (pdf format)

Colon Cancer is the third most commonly occurring cancer and the second leading cause of death (from cancer) in Kentucky. Data from the Kentucky Cancer Registry show that there are an estimated 2,753 new colon cancer cases diagnosed and 930 deaths from colon cancer annually.

We are not helpless against this type of cancer. If detected early, through regular screenings, the cure rate is higher than 90 percent. There are also a number of lifestyle changes that can be made to lower the risk of developing the disease. Screenings and early detection are crucial in treating this disease. Both men and women are at risk of developing colon cancer. Screenings are encouraged because they can detect problems, such as polyps, which can develop into cancer, but can be easily removed when detected early. The goal is to not only raise awareness about colon cancer, but to drive patients toward their first screening and educate them about the warning signs which require immediate medical attention.

The Bottoms Up Team partnered with the Colon Cancer Prevention Project to produce a live television broadcast, collect caller demographics, conduct a post-broadcast survey, hold focus groups, and submit a request to the Behavioral Risk Factor Surveillance System for an additional questionto the2008 survey. The team reviewed the proposed script, designed caller demographic collection tool, designed post-broadcast survey, assisted with telephone bank logistics and collection, reviewed viewer demographics (provided by the television station), and reviewed consumer profiles for the viewing area.

Systems Issues Impacting Adequate Services for Postpartum Depression in Louisville Metro

Prepared by: Paul Freibert, MUP; Leanne French, MS; Kay Heady, BSN; Sarojini Kanotra, PhD, MPH;
Deborah Snow, BS
Mentors: Richard Wilson, PhD; Carla K. Baumann, RN, MSN

Full Report (pdf format)

This KPHLI Change Master Project focused on a systems-level analysis of issues limiting adequate care for Healthy Start program clients in Louisville Metro affected by postpartum depression.

The Healthy Start program is a federal initiative operated by the Louisville Metro Department of Public Health & Wellness (LMPHW). Healthy Start staff members have observed that mothers who screen positive for postpartum depression either do not accept a referral for further counseling or do not keep their appointment. This is supported by data obtained during a grant performance review when only 7.3% of the clients that screened positive kept their referrals in 2006.

To identify barriers to follow-up, the KPHLI team collected qualitative data from Healthy Start clients, their friends, partners and family members, Healthy Start staff members, and providers of services for postpartum depression in the community. We identified barriers to follow-up for postpartum depression care similar to those identified at the national level. These barriers will be addressed through collaborative efforts to involve Healthy Start clients, staff, and direct service providers. Ongoing work is needed to build collaboration with stakeholders at all levels to structure and improve services and increase completed referrals for women with postpartum depression.

Public Health Nursing: An Opportunity to Explore, Strengthen, and Experience

Prepared by: Wendy Keown, RN; Renee Nall, RN; Corey Patterson, BS, RS; Cynthia Phillips, RN;
Laura Woodrum, RN, BSN; Monica Hall, RN
Mentors: Scott D. Bowden, MPH, BS, AS; J. David Dunn, MPH, DrSc In Hyg

Full Report (pdf format)

The TEAM RN 2007-2008 KPHLI group began their year by recognizing that health departments are having difficulty recruiting qualified Registered Nurses. While nursing schools are graduating more nurses than ever before, the number of RN applicants in the health departments has decreased.

Over the past several years, there has been a loss of experienced public health nurses due to retirements, and there is projected to be an even greater loss by the end of 2008. With new emerging public health threats, it is more important than ever to have a strong and experienced public health workforce. TEAM RN decided to focus our efforts on R.N. recruitment issues in public health.