Brennen, Marlene

Geographical and health-related obstacles frequently prevent veterans from receiving care from civilian hospitals and the Veterans Health Administration. Due to poor patient education and lack of access to mental health care, many patients with serious mental health illnesses have no choice but to go to emergency care for mental health treatment that could be treated effectively in an outpatient setting. An initiative identifying the factors that lead veterans to the emergency room for preventable mental health services has the potential to improve public health. Home-based mental health care can be provided in many modalities, including telehealth, video conferences, and in-person (face-to-face; In addition to eliminating transportation issues, improving access to mental health services, and reducing the stressors of waiting for appointments in outpatient clinics.
The project was conducted with veterans enrolled in a home-based primary care program at a Southwest Region Hospital. A total of 15 male veterans between the ages of 55 and 85 agreed to participate. Six were African American (40 %), 5 were White (33 %), and four were Hispanic (26.6 %). A repeated measures ANOVA was conducted on PSS-10 scores. The main effect for the within-subjects factor was significant, F(3, 42) = 41.59, p < .001, indicating there were significant differences between the values of Pre-Intervention PSS-10 scores, Month 1 Pss-10 score Month 2 Pss-10 score, and Month 3 PSS-10 scores. A Repeated Measure ANOVA was conducted on Psych ER visits. The main effect for the within-subjects factor was significant, F(1, 14) = 93.04, p < .001, indicating significant differences between the values of Pre-intervention Psych ER visits and Month 3 Psych ER visits.

Hypertension is a major health care challenge. Uncontrolled hypertension is a huge
financial burden in the United States. Strict medication adherence and lifestyle modifications
such as incorporating a low sodium diet and increasing daily aerobic physical activity have
been proven to be effective in managing hypertension. However, uncontrollable
hypertension continues to be one of the most leading causes of cardiovascular disease and
death worldwide. When compared to other groups, Haitians have a higher disproportionate
risk of morbidity and mortality from chronic disease. The purpose of this quality
improvement project was to evaluate the effectiveness of physical activity through a walking
exercise program and hypertension self-management education on blood pressure in Haitian
adults aged 35 to 84 diagnosed with hypertension in the primary care setting. The project
was an 8-week online/remote walking exercise program designed to provide bi-weekly
hypertension self-management education sessions (moderate-intensity physical activity, low
salt diet management, and medication adherence teaching), weekly self-adjusted step goals,
and weekly one-on-one physical activity nurse counseling via telephone/video
teleconference. The study results showed that participants who were fully engaged in the
walking exercise program were able to manage their blood pressure by increasing their
physical activity level, adhering to a low sodium diet, and increasing medication adherence.