Collaborative Research Between Academic and Clinical Institutions:

An Academic Nursing, Clinical, and Community Partnership to Identify and Meet Rural Community NeedsSheila Q. Hartung, PhD, RNBloomsburg UniversityBloomsburg, PA1S.Q. Hartung, 2012An Academic Nursing, Clinical, and Community Partnership to Identify and Meet Rural Community NeedsPresenter Disclosures(1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:Sheila Q. HartungNo relationships to disclose

IntroductionResearch and collaboration focus of key playersGeisinger Center for Health Research, Dr. Sharon LarsonSullivan County SHIP, Joan GruverBloomsburg University, Department of Nursing, Dr. Sheila HartungApproval and supportIntent Identify perceived health status and barriers to accessThe project and research Community Needs Assessment (including Focus Groups and Community Survey) GMC, Center for Health ResearchCommunity Assessment and Insight Interviews BU, Community Health/Public Health Nursing courseCommunity Interventions GMC, BU, and SHIP3Collaboration of GMC Center for Health Research and Sullivan County SHIP Summer 2009Responsibilities - Focus groups and community surveyFocus group meetings performed withSullivan County SHIP partners community health and human service agency representatives educational institutional representatives mental health consumer support group members regional EMS council members County Commissioners office hospital representatives4Intent of Focus Group DiscussionsCharacteristics of a good community Areas of community need Preventative health care programs available Noted health problemsAccess to health and human services

Employment and resources both within and surrounding the county Access to and availability of transportation services Demographic profile of county residents Intended resident survey questions5Bloomsburg UniversityDepartment of NursingCommunity/Public Health Nursing courseResponsibilities General Community Assessment and Insight InterviewsCourse overviewClassroom and clinical componentsPublic health approachHealth promotionDisease preventionEpidemiology6Community Assessment FrameworkSystems approachObjective dataMorbidity and mortality dataSecondary data (i.e., School Health Index)Subjective dataObservation (i.e., windshield surveys)Key informant interviews and Insight InterviewsAttendance at community meetings

7Students as leaders and collaboratorsGroup process, theory, techniques, rolesLeadership principlesFollowership principlesCollaboration with faculty, community groups, key informants in the community

8Analysis of DataInferencesProblem identificationCommunity nursing diagnosisHealthy People Objectives

9InterventionHealth Promotion Project implementationEvaluationContentProcess

Community/Public Health Nursing courseFall 2009 & Spring 2010Course focus in Fall semesterBU IRB approval, contacts and collaboration with Sullivan County SHIP, recruitment of Insight Interview participants, Insight Interview data collection, collection of abbreviated CA parameters (Physical Environment, Demographics, Vital Statistics, Behavioral Risk Indicators, Economics) Course focus in Spring semesterInsight Interview analysis, dissemination of Insight Interview results to collaborating partners, collection of abbreviated CA parameters (Physical Environment, Demographics, Vital Statistics, Behavioral Risk Indicators, Health and Social Services, Education, Politics and Government)

10Community Assessment Highlights of County

Windshield SurveysSpring semesterDushoreLaporteLopezBernice/SatterfieldMildredEstellaColley

Fall semesterDushoreLaporteLincoln Falls, Shunk, WheelervilleHillsgroveEagles Mere, Muncy Valley, Beech GlenMillviewForksville

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Community Assessment ParametersPhysical EnvironmentDemographicsVital StatisticsBehavioral Health IndicatorsEconomicsHealth and Social ServicesPolitics and GovernmentEducation13

Leading Cause of Death per County Annual Average Rate per 1000 Residents 2003-200814

Heart Disease Death Rates Per 100,000 (2007) (Age Adjusted)

(Pennsylvania Department of Health, 2007, a2)1515S.Q. Hartung, 2012An Academic Nursing, Clinical, and Community Partnership to Identify and Meet Rural Community Needs

Mortality: All CancersMortality Rate from cancer among All Ages across 3 different 3 year time spans per 100,000.(Pennsylvania Department of Health, 2008, e4, f4)1616S.Q. Hartung, 2012An Academic Nursing, Clinical, and Community Partnership to Identify and Meet Rural Community Needs

Percentage of Healthy Weight Adults 2003-2005(BMI of 18.5-24.9)(Pennsylvania Department of Health, 2005, b1)1717S.Q. Hartung, 2012An Academic Nursing, Clinical, and Community Partnership to Identify and Meet Rural Community Needs18Adults Who Admit to Currently Smoking:2005-2007 Results by Age GroupPA DOH, Epidemiologic Query and Mapping System. http://www.portal.state.pa.us/portal/server.pt?open=514&objID=596553&mode=2 (2005-2007)

Percentage of Suicide 2000-2007

(Pennsylvania Department of Health, g7)1920Educational Attainment: Population 18-24 years (US Census 2000)

Median Household Income 20072121S.Q. Hartung, 2012An Academic Nursing, Clinical, and Community Partnership to Identify and Meet Rural Community NeedsInsight Interviews

22Data Collection Fall 2009IRB approval for Insight InterviewConnection and presentation at SHIP meetingsRecruitment processHealth and human service partners approached residentsGave summary/intent of researchIf participant agreed, gave participant contact name and number to study investigator

23Data Collection Fall 2009Study investigator gave contact name and number to BU student pair to contact for interviewStructured and semi-structured interviews of 9 residents performed by BU senior student pairs in the residents home or other convenient locationInterview guide and scriptRoles of interview pairField notesIdentifying informationSubmitted detailed field notes and beginning analysis conclusions to study investigator 2425Analysis Spring 2010Small group of 6 students within the course volunteeredOrientation meeting of small groupSmall group coded and analyzed one interview together manually Coded remaining 8 Insight Interviews using QDA software (ATLAS.ti)Themes and commonalities from data collectedCommunity, Family, Health, WorkDeveloped subcategories for each themeGave examples for each category Conceptual model to illustrate life in Sullivan County

Bloom in Sullivan County26Health Promotion Projects27

Health Promotion ProjectsFall 2009All collaborative partnersHealth Fair (Oct.)All populationsImmunizations, health screenings, diet/nutrition, resources, chronic disease, exercise/activityLocation/venue: elementary school

BU, DONHealth Fair Flurries of Health (Dec.)Adult to older adult populationHeart disease, diabetes and obesity, cancer, mental health and wellness, risky behaviors Location/venue: church hall in conjunction with holiday craft fair

28Health Promotion ProjectsSpring 2010BU, DONRotating stations Hunt for Health (April)Adolescent populationEnvironmental health, mental health and wellness, safe sexual practices, drug and alcohol use and abuse, healthy lifestylesSullivan County Junior/Senior High School, Laporte

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Lessons LearnedUndergraduate students can be active participants in collaborative research or projects with specific delineated roles.As an essential component of baccalaureate education, students are able to gain needed practical application of the core functions of public health, health promotion and disease prevention, leadership and management principles, and effective group process with large and small groups. Illustrates for students the concepts basic to nursing practice: community and partnership for health. Further solidifies the contribution and benefit to the community and its residents through a connection with both the academic institution and a major health system.

30Lessons Learned (contd)Continued contact in the rural area beyond the research timeframe is challenging due to the rural location and distance from educational and clinical institution Planned and sustained contact for ongoing assessment and health promotion is needed during the planning phases of the partnership

31RecommendationsContinue collaboration within the communityLook for do-able research and project componentsGreater student preparation for qualitative data analysis and codingAccessible QDA software package and common files on-campus for faculty and students during projectIncrease time allotted to analyze as a small groupAllow time to incorporate findings and analysis of interviews into survey dataDisseminate analysis to collaborating partners more quickly 32

33Thank You!Questions??Chart1258.2214.9200.9212.7166

Sullivan CountyPennsylvaniaBradford CountyForest CountyHealthy People 2010

Sheet1Sullivan CountyPennsylvaniaBradford CountyForest CountyHealthy People 2010Death Rates for Heart Disease258.2214.9200.9212.7166To resize chart data range, drag lower right corner of range.

Chart1211.7205.5181219.41999-2001156.6198.7188.4177.62002-2004197.6194189.5172.32005-2007159.9

Sullivan CoPABradford CoForest CoHP 2010

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Chart160Healthy People 2010Healthy People 201039PennsylvaniaPennsylvania34Bradford, Sullivan, Tioga, Lycoming, Clinton, PotterBradford, Sullivan, Tioga, Lycoming, Clinton, Potter

Series 1Column1Column2Percentage of Adults

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