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Educating Community Health Workers: To improve Maternal and Infant Health in Rural Areas
No full textBackground
Community Health Workers (CHW) are lay workers who are beneficial in reducing health disparities, in their communities. They provide culturally sensitive home visits and help coordinate resources for their patients. These visits have been shown to benefit the psychological, behavioral, and social health of their patients.
Local Problem
Despite the benefits of CHW involvement, they lack standardized training that could improve their services.
Methods
A partnership was entered by the University of San Francisco (USF) and an international philanthropic organization, focused on helping children. The partnership developed a certification program for CHWs in the Tulare County with USF Nurse Practitioner (NP) students providing the educational component.
Interventions
This intervention, part of a broader curriculum, focused on postpartum women and infant health for the CHW certification program. USF NP students created a curriculum which included: three PowerPoint presentations, canvas modules, and pre and posttests to gauge learning.
Results
CHWs showed improvements in knowledge after each of the three teaching sessions. Post tests showed improvements from pretests in standard deviation, and average, high, and low scores. Average testing time varied for post scores between the teaching sessions.
Conclusions
CHWs verbalized feeling of increased confidence in their skills. Their pre and post surveys revealed retained knowledge to use with their patients. Future changes to the surveys could include quantifying confidence levels before and after the classes. Overtime, as the CHWs retain new knowledge they can form stronger connections with their patients and give more sound medical and practical advice.
Key words: Community Health Workers, Nurse Practitioner students, postpartum care, educatio
Trauma-informed Care: A Therapeutic Communication - Executive Summary
No full textBackground Effective therapeutic communication is essential for building strong patient relationships, yet bias, stigma, and judgment can exacerbate trauma and widen health disparities. Trauma-Informed Care (TIC) emphasizes respect, compassion, and empathy to mitigate these issues. Problem Although TIC is extensively studied in high-income regions such as the United States, Europe, and Australia, its application in developing countries remains limited. This gap impedes culturally sensitive healthcare practices that address unique social, cultural, and economic challenges, potentially deepening disparities. Methods A comprehensive literature review was conducted to assess current TIC training research among healthcare workers. The review aimed to underscore TIC\u27s importance in medical practice and identify strategies to enhance provider knowledge, attitudes, and skills. Interventions A quality improvement project was implemented in Chogoria, Kenya, involving 16 healthcare workers. Utilizing a single-group pretest–posttest design, participants attended a one-hour PowerPoint presentation on TIC and subsequently participated in exploratory qualitative interviews. Results Post-workshop surveys demonstrated a 3% increase in TIC-related knowledge, attitudes, and skills. Qualitative analysis identified three emerging themes: the relevance of TIC, the impact of cultural stigma and bias, and the need for additional community resources. Conclusion This study highlights the critical importance of extending TIC practices to resource-limited settings like Chogoria, Kenya, where tailored interventions can significantly enhance patient care and promote holistic healing while reducing health disparities.
Keywords: adult trauma, adverse childhood events, harm reduction trauma-informed car
Trauma-informed Care: A Therapeutic Communication
No full textAs medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural community clinic in Chogoria, Kenya. Objectives were achieved through pre- and post-workshop surveys and exploratory qualitative interviews conducted after an in-service workshop on Trauma-Informed Care (TIC). Healthcare workers demonstrated a 3% increase in knowledge, attitudes, and skills in postsurvey results following an in-service workshop on TIC. Analysis of focus group narrative data revealed three themes: relevance, cultural stigma and bias, and additional needs in the community. TIC’s therapeutic communication helps to mitigate biases and stigma, foster empathy, and address patient trauma, ultimately reducing health disparities. The findings of this study indicate further research regarding TIC should be conducted in LMIC to identify ways in which providers can enhance the quality of health care delivery and promote holistic healing.
Keywords: adult trauma, adverse childhood events, harm reduction, trauma-informed car
Fact-Finding Is An Immigration Lawyer\u27s Job: The Importance of Working One-on-One with Clients in Asylum Cases
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From Shield to a Sword: Using the Dormant Commerce Clause to Challenge State Laws Promoting Fossil Fuels
No full textCan an LLM Use Work System Axioms when Describing Work Systems for Requirements Analysis?
No full textThis research-in-progress paper presents part of an ongoing project related to using LLMs for describing, analyzing, and designing work systems (including information systems). General axioms that apply to any non-trivial WS or IS might provide a path toward new tools and methods. This paper identifies 24 work system axioms that extend earlier research. They are organized in five categories: 1) system in context, 2) system operation, 3) system goals and goal attainment, 4) system uncertainties, and 5) system-related change. The axioms potentially address the challenge of helping business and IS/IT professionals understand and collaborate around systems in organization. This preliminary research hints at the potential value of the axioms based on results when an LLM applied them to two case studies
Pressure Free Care: Empowering Staff With the HAPI Prevention Reference Sheet, A Quality Improvement Project
No full textHospital-acquired pressure injuries (HAPIs) can significantly impact a patient’s quality of care, increase organizational costs, and pose significant risks for patient safety. According to the United Hospital Fund, “Hospital-acquired pressure injuries (HAPIs)—also known as pressure ulcers or bed sores—can pose significant problems for both the patient and hospital. Being an injury to the skin or underlying tissue, HAPIs can be painful, cause infections, hinder recovery, and prolong a patient’s time in the hospital” (United Hospital Fund, 2025). This quality improvement (QI) project took place in a small, urban southern California hospital with a high incidence and prevalence rate of HAPIs (compared to the national benchmark) in a medical-surgical unit. After an initial discussion with the organization’s only wound care nurse coordinator (WCC), the team discovered interventions they have attempted to implement within the units, such as a leaf-turning system, four-eye skin assessments, skin champions, and mandatory educational sessions on ways to prevent pressure injuries- all of which have been successful according to evidence-based practice. Despite attempts at evidence-based implementation, the unit continued to experience high rates of pressure injuries, attributed to various contributing factors. In collaboration with the WCC for our primary intervention, we developed a visual reference guide that contains current supplies on the unit and example photos of the stages of pressure injuries. The current reference guide on this unit was found to be outdated and difficult to access for unit staff. Therefore, creating an updated visual reference guide was our main focus for the intervention. Evaluation of data will be carried out by the following cohort, using quarterly incidence and prevalence studies of pressure injuries acquired within the unit. Once the updated visual guide is implemented, the team hopes to see a 1% monthly decrease in the incidence and prevalence of HAPIs. The goal is to provide the staff with an easily accessible resource that they can utilize when treating and staging pressure injuries
Implementing Age-Appropriate, School-Based Comprehensive Sexuality Education
No full textBackground: Sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion. Yet, there are no federal education requirements for sexuality education in the United States, leading to inconsistent and inadequate instruction.
Methods: In an effort to better understand the barriers beyond policy variability that affect successful implementation of SRH education, a literature search was conducted on CINAHL and ERIC with the following search terms and Boolean operators: (sex* education OR reproductive educat*) AND (elementary school OR school based) AND (United States OR California). The years of publication were limited to the past five years (i.e. 2020 to 2025) and the inclusion criteria focused on school-based SRH education in the United States, ultimately leading to 12 articles for the literature review.
Results: While educators and healthcare providers both acknowledge the importance of initiating SRH education at a young age, both groups remain underprepared to deliver this education effectively due to inadequate training, lack of institutional support, curriculum variability, and limited resources.
Conclusions: There is evidence that supports collaborative, community-based methods to mitigate the need for increased SRH literacy, including existing programs and guidance by theoretical frameworks. It would be worthwhile for future initiatives to focus on collaborating with key stakeholders under the guidance of the Whole School, Whole Community, Whole Child model to develop and implement sustainable SRH curricula that aligns with the National Sex Education Standards
