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Project Horizon Recent Innovations

Background

Nurse students supported by academic researchers carry out initiatives to advance outcomes in health, care and well-being in homeless shelters, transitional living centers, urban schools, and neighborhood centers. Recent Project Horizon innovations centered on cardiovascular and pulmonary health, exercise and diet, communicable disease prevention, and on health education related to breast and prostate cancer, HIV, obesity and diabetes. Common Community-Based Participatory Research elements include fostering co-learning, the use of culturally appropriate intervention strategies, a focus on the community as the population unit, the active collaboration of participants in every stage of the research process, and the dissemination of project findings in understandable terms. These Project Horizon intervention and evaluation projects aim to translate scientific knowledge on a wide range of disease prevention and health maintenance topics into practice and are examples of translational research.

Ten Recent Innovations

In Using Collaboration to Increase Health Awareness, researchers developed an interactive health awareness and disease prevention program for an urban men’s shelter. Three sustainable prevention strategies were designed and implemented with a measurable increase among the target population in healthy behavior modification and a concomitant increase in self-esteem. The project was carried out by Jennifer Nabors BSN, RN and Colleen Smart BSN, RN in coordination with academic faculty.

What’s Cooking? - Increasing Nutritional Awareness is a comprehensive diet education program designed for tenets living in a low income urban single occupancy apartment complex after a needs assessment identified a lack of nutritional knowledge as a major health concern for this underprivileged population group. Specific information related to hypertension, high cholesterol, diabetes, constipation and acid reflux was included. Results from evaluation and participant feedback of the education program revealed an increased awareness and knowledge of the nutritional impact on individual health issues, diet modification, healthier food selection and preparation. The dissemination of a population-specific cookbook reference tool was viewed as an integral element in the sustainability of the knowledge transfer process. The project was carried out by Trina Boyce, BSN, RN, Aleks Frenkel BSN, RN and Laurie Scarpo BSN, RN in coordination with academic faculty.

Closing the Gap on Health Awareness and Homelessness - A Health Literacy Campaign focused on the lack of targeted health promotion that exists in homeless shelters. A health literacy campaign on drug addiction, mental illness, hypertension, diabetes and tuberculosis was created with the input of a men’s shelter community. Bilingual registered nurse students designed The Voice (La Voz), a setting specific weekly health newsletter and reinforced the content with live discussions and interactive presentations. The interventions - rated as highly informative, helpful, easy to understand, and relevant - were seen as a successful means of transmitting health information in a culturally appropriate manner. The project was carried out by Nanci Moran, BSN, RN, and Sarah Cunha BSN, RN in coordination with academic faculty.

Staying Healthy as you Age - An Exercise and Diet Initiative to Maintain Health in Older Adults - Senior lifestyles in low income urban neighborhoods tend to be sedentary and meal portions are often larger than needed with inadequate fruits and vegetables. A lack of dietary awareness and strong cultural norms around dietary patterns in one African American senior center community exacerbated the issue. After building rapport researchers and senior center participants designed an education program for age appropriate physical exercises, culturally specific meal plans, and potential food and drug interactions. Participants demonstrated recommended meal portions, successfully identified foods that would interact with their currently prescribed medications, and reported an increase in weekly exercise and beneficial diet modifications. Phase two will focus on system-wide changes as well as continued cultural assessment for appropriateness. The project was carried out by Juleen Cooper, BSN, RN, and Juanita Gonzales BSN, RN in coordination with academic faculty.

Promoting Healthy Eating and Exercise to Decrease Childhood Obesity - Childhood obesity is a costly, nationwide problem leading to many disease processes. It worsens with the over-consumption of foods lacking in nutritional benefits and a lack of physical activity. An educational plan was designed in an urban school that allowed children to demonstrate increased knowledge of proper nutrition by making better food choices and by decreasing the intake of fatty and high caloric food and beverages. School children also actively participated in physical education opportunities. The project was carried out by Maryann Lachapelle BSN, RN in coordination with academic faculty.

Are you Ready to Clear the Air? A Proposal for a Smoke Free College Campus -Cigarette smoking on college campuses is a health problem. Inhalation of cigarette smoke and second hand smoke are directly related to the development of major health problems later in life. Stressors inherent in college life make students vulnerable for beginning or increasing smoking. This project is part of a wider University of Hartford initiative to make the campus smoke free. The researcher engaged in campus conversations and a survey among the college community to gather preliminary data. Then, using evidence based practice guidelines (rnao.org), a four year plan was proposed starting with designated outdoor smoking areas, moving toward a ban of smoking in academic areas, and onward to a total smoking ban. In conjunction with tobacco policy restrictions, the University of Hartford will support quitters by offering smoking cessation programs, stress reduction techniques, nicotine replacement therapy or prescription medication and telephone quit support. When the smoke-free plan is implemented, the University of Hartford will become a model for other campuses to follow. The project was carried out by Cora Ekwurtzel BSN, RN in coordination with academic faculty.

My Sister’s Health – An Educational Program to Raise Awareness of Preventative Health Care and Immunization Schedules for Displaced, Urban Women -  Women residing in transitional living centers often have insufficient knowledge of necessary health screenings pertaining to breast and reproductive health and childhood immunization protocols. To increase knowledge of recommended health guidelines, registered nurse students presented health teaching episodes and open discussions on sexually-transmitted diseases, health screening recommendations, and self-breast examinations. Wallet-sized reminder cards were created for women to record preventative health screening and immunization dates and a health screening schedule handbook was left with the agency staff. Further system-wide changes are needed to imbed the new knowledge into sustained practice. The project was carried out by Lisa Roy, BSN, RN, and Carol Woltersdorf BSN, RN in coordination with academic faculty.

Increasing the Availability of Fresh Fruits and Vegetables in Soup Kitchens – Fresh fruits and vegetables are costly, perishable and difficult to transport. Urban soup kitchen menus have few fresh items and the need to increase the availability of these food items is great. Guests who eat at soup kitchens are at risk for diabetes, hypertension and obesity and may have little current nutritional information. The availability of fresh fruits and vegetables on soup kitchen menus can help to promote healthy eating. Researchers used collaborative methods to develop rapport, assess need, plan and evaluate interventions. Weekly wellness program sessions with open forums were created to discuss nutritional issues, weekly dietary logs were kept by guests and a series of educational presentations were offered. Educational sessions for staff focused on how to locate and purchase fresh fruits and vegetables in bulk and a list of area resources on menu planning and food vendors was provided. The availability of fresh fruits and vegetables on the soup kitchen menu increased from 2 to 3 portions per week to 4 to 6 portions per week – a 100% increase. Ongoing staff engagement in the project is critical in sustaining the outcomes. The project was carried out by Fritzner Charles BSN, RN and Francesca Amoah BSN, RN in coordination with academic faculty.

Music for Social Change – Enhancing Socialization through Music Relaxation – Adult guests with substance abuse and mental health disorders living in transitional centers have decreased cognitive and behavioral function and increased social isolation. Psychiatric mental health nurse students developed a community-driven music relaxation enrichment program. Music sessions incorporated dancing, singing, playing instruments and listening to favorite songs chosen by the community. To promote sustainability, a collection of favorite music was compiled on compact discs for future activities. Participants showed an increase in social interaction and engagement in conversations, greater relaxation and comfort in community, and a positive change in cognitive and behavioral function. Also, the time participants spent in community with one or more persons increased. The project demonstrates that setting-specific enrichment programs can increase socialization among persons with a dual diagnosis living in transitional settings. The project was carried out by Karin Remicio BSN, RN and Pamalyn Lalor-Kanhai BSN, RN in coordination with academic faculty.

Open Heart, You Are What You Eat – Nutrition Education for the Most Vulnerable -A needs assessment revealed poor dietary habits and a lack of nutritional knowledge in guests living in an institution that housed homeless shelter and transitional living guests, many of whom suffered from long-term substance abuse and mental health issues. Also, a higher than average incidence of diabetes, hypertension and high cholesterol was noted in this population. After developing trust in the community nurse students, using input from staff members and agency guests, created setting-specific bilingual diet educational resources intended to enable participants to make healthier diet choices. Topics included carbohydrates and diabetes, hypertension and sodium intake, and cholesterol and fats. Participants increased knowledge awareness, reported making healthier meal choices and increased their consumption of healthy snacks. Also, they were better able to understand food labels and increasingly chose water over carbonated beverages to drink. A long-termed sustainability plan is needed. The project was carried out by Carmen N. Cardillo BSN, RN, Jessica Cruz BSN, RN and Rose-Ann Richards BSN, RN in coordination with academic faculty.