Pritchard, Kyndall

When treating and studying mental health we must identify all of the factors that play a role in mental stability. Basic needs such as access to water, food, and resources can play a significant role in mental stability and can increase or decrease the likelihood of triggering, exacerbating, or eradicating a mental illness. Human beings need their basic needs met in order to have a healthy foundation and tackle mental and medical disorders. Scholarly evidence shows a positive correlation between food insecurity and moderate to high levels of psychological distress. Inadequate access to food increases the probability of disorders, psychotic breakthroughs and/or exacerbation of psychiatric illnesses. Individuals with mental health disorders are at risk for poor food security. The DNP project created and implemented for quality improvement assess clinicians’ willingness to implement the Food Insecurity Experience Survey (FIES) in an adult inpatient psychiatric stabilization and residential setting after the completion of an educational program. Project evaluation involved the Evidence-Based Practice Assessment Survey (EBPAS), a pre- and post-test surveys on FIES knowledge, and a post-test on the usefulness of the educational program. Analysis revealed significance improvements in the Openness, Appeal, and Requirements subscales of the EBPAS. Items on the pre- post-test survey on FIES knowledge were statistically significant. Likewise, the results revealed significant satisfaction with the educational program. Facilitators of the project concluded that the project outcomes illustrate the utility of an educational program on the implementation of FIES for food insecurity screening in mental health settings.

Hypertension affects nearly half of all adults in the United States (US) or 108 million individuals, and one out of every four adults is affected (Centers for Disease Control and Prevention [CDC], 2020). Furthermore, more than 30% of individuals with hypertension in the United States do not take their medication as directed, increasing the risks of stroke, heart disease, diabetes, and morbidity and death rates among Afro- Caribbean adults with HTN (CDC, 2020). Non-adherence is a leading cause of health issues in the treatment of chronic disorders like hypertension. Furthermore, these negative consequences exacerbate preexisting health issues in disadvantaged communities, necessitating self-management and medication adherence improvements (Moss, 2019).
This quality improvement (QI) initiative aims to enhance health outcomes for Afro-Caribbean individuals diagnosed with HTN at the Cora E. Braynon Family Health Center between 40 and 70. Barriers to non-adherence are a leading source of health problems and chronic illness management in HTN (CDC, 2020). According to Whelton (2017), self-care management also helps to reduce obstacles and injustice in high-stress or underprivileged populations. The following section presents a team learning to take control (TLC) approach that can offer bi-weekly sessions to improve patient blood pressure readings, sleeping patterns, pain control, communication, and eating habits (Still et al., 2018).

Medication non-adherence constitutes a significant barrier to the effective management of diabetes and can place a severe burden on healthcare system. Despite the development of new medications, diabetes remains the 7th leading cause of death in the United States (Hirsch et al.,2021). This quality improvement project was conducted in a primary care setting to assess and improve medication adherence.in adults with diabetes. The adherence to medication was measured by the Adherence Starts with Knowledge-12(ASK-12) survey. The interventional strategies included medication-specific education, self-management of glucose monitoring, and a follow-up program using telephone calls, text messages, or mobile health applications. A total of eighteen eligible participants' ((72.2% female; mean age 62.06 y; 94.4% Afro-Caribbeans) ASK-12 questionnaire scores (pre and post) and Hemoglobin A1c (HgA1c) (pre and post) level were used for final data analysis. A paired sample t-test of ASK-12 scores demonstrated an improvement in medication adherence, from an average of (M=30.28, SD=6.28) on the pre-test to (M=14.39, SD=2.15) on the post-test [t (17) =12.14, p < 0.001, Cohen’ d=2.86]. A paired sample t-test of HgA1c results were also statistically significant with a decrease of the HgA1c from an average of (M= 9.1, SD=1.76) on the pre-test to M=7.9, SD=1.14) on post-test, [t (17) =5.49, p < 0.001, Cohen’s d =1.293]. This project highlights the positive impact of routine monitoring, medication-specific education, and follow-up reminders on improving medication adherence and glycemic control.