GradCon Abstracts (circa 500 words) must include the following elements (as applicable to your field): Your abstract/artist statement must be specific to this presentation. It should be revised to reflect your most recent work on the project.
- Title – Describe your topic in language that is intelligible to a general audience.
- Purpose – State your main thesis or rationale.
- Methods – How did you carry out this project?
- Originality – What is new about this approach?
- Significance – Explain the contribution of this project to your field and/or to society.
Evaluating Montana's Baby Friendly Hospital Initiative
The evidence linking multiple positive health outcomes such as decreased risk for gastrointestinal disorders, obesity, allergies and ear infections for babies that are breastfeed is well supported by research . There are also known health benefits to mothers who breastfeed including reduced risk of breast and ovarian cancer . Despite this evidence, two-thirds of mothers who intend to exclusively breastfeed do not meet their breastfeeding goals . In Montana, 50.7% of babies are breastfed until 6 months; which is below the Healthy People 2020 goal of 60.6%. The Baby Friendly Hospital Initiative (BFHI) is a global movement established in 1989 by the World Health Organization and The United Nations Children’s Fund to implement policies and the best practices in hospitals to support optimal infant and mother’s nutrition. The Montana Nutrition and Physical Activity Program (MT NAPA) has created a partnership with the Montana Women, Infant and Children’s Program (WIC), the Montana State Breastfeeding Coalition and birthing facilities around the state to promote breastfeeding initiation and duration through community-clinical linkages of support. Currently Montana has 2 hospitals that are designated as Baby Friendly Certified. The MT NAPA collaboration is working with 11 facilities throughout the state to navigate through the 10 Steps to Successful Breastfeeding to become Baby Friendly Designated Facilities. The success and implementation of this 10 step process is evaluated by the Maternity Practices in Infant Nutrition and Care (mPINC) survey. The survey is administered every two years by the Center for Disease Control (CDC) to monitor and examine changes in practices over time at all hospitals and birth centers with registered maternity beds in the United States. The survey is completed by a staff member that plays a key role in these practices. The last available mPINC data is from the year 2013. The 2013 data will be analyzed to compare breastfeeding practices collected through the mPINC survey in MT facilities that are engaged in the baby friendly process and also those who deliver babies and are not engaged in the process. When the 2015 data becomes available, comparisons will take place among the engaged hospitals to see if their mPINC scores have risen after engagement in the BFHI has taken place. Many factors within the community and the healthcare system have an effect on breastfeeding initiation and duration rates. The MT NAPA Program along with its partners are working to increase rates through collaboration among healthcare providers and the community. Although data is limited in the areas of breastfeeding rates comparing Baby Friendly engaged hospitals vs hospitals not implementing the practices, initial numbers point in the direction of the benefits of becoming Baby Friendly and the positive impact those practices have on breastfeeding rates. As more facilities in MT become Baby Friendly Designated, the opportunity to compare and contrast data among those facilities will be available.
Addressing Barriers to Childhood Vaccination Through Community Partnership
The National Immunization Survey reported that in 2004 28% of parents were unsure about, delayed, or refused childhood vaccines altogether.1 Reasons for low vaccine coverage in the US include: parents’ concerns and beliefs that vaccines are unsafe and are given too many at a time, are too painful, and distrust of the medical community.2 According to America’s Health Rankings, Montana ranks 41/50 nationally for immunization coverage.3 A lack of vaccine coverage exposes unimmunized children to disease, and weakens our population immunity, making outbreaks of vaccine preventable diseases a constant threat.
The Flathead City-County Health Department, in conjunction with area immunization providers, started an Immunization Coalition, with the aim of addressing low vaccine rates in Flathead County. The coalition aims to increase communication between area providers and the health department in efforts to ensure consistent and appropriate delivery of vaccines according to the current Centers for Disease Control and Prevention schedule, which is complex for the 19-35-month age group. The coalition also aims to increase immunization rates through decreasing environmental barriers, correcting myths around vaccine safety, and normalizing the idea of vaccination in the community.
After a review of the literature, many evidence-based interventions aimed at increasing vaccination rates were identified. According to The Community Guide, provider-patient education and educational pamphlets alone are ineffective at consistently raising vaccine rates. The recommended interventions do include reminder recall systems, the use of a statewide immunization database, school and daycare vaccine requirements, and home visiting and family financial incentives. Provider patient education through discussion or written material, and community wide media campaigns are recommended when done in conjunction with other aforementioned interventions.4
The literature strongly supports addressing environmental and practice barriers over education for increasing vaccination rates. Given this information the Immunization Coalition will first assess consistent and correct vaccine delivery for the 0-2 age group in Flathead County. This presentation will summarize the findings from a series of key informant interviews and needs assessment surveys conducted with representatives from all coalition partners. In addition, the presentation will describe possible interventions weighted according to perceived need and strength of evidence for effectiveness. Plans for a community wide intervention to be carried out during summer and fall of 2016 will be described as will the evaluation process.
Adult Day Services: Quality Care for All
It is anticipated that the population of those 65 and older in Missoula County will reach 19% by 2030. The Missoula Coalition on Aging and Disabilities (MCOAD) is a community group whose purpose is to address the concerns and needs of aging Missoula residents. MCOAD conducted a community needs and interest survey of adults 55 years and older in the fall of 2015 in recognition of this growing population and potential growing needs.
Alzheimer’s disease and related disorders (ADRD) was identified as an area of interest for Missoula residents. Alzheimer disease is ranked as the 6th leading cause of death for Americans as reported by the National Alzheimer’s Association. Although research has yet to identify any causative agents or cures, many associations with comorbidities have been identified. This complicates the care of those with ADRD. The burden of care often falls to spouses or adult children with an associated cost of approximately $41,000 to $56,000 annually according to the National Institute on Aging. Care givers who opt to care for persons with ADRD outside an institution face the additional risk of developing caregiver burnout and depression. Adult day services (ADS) is a growing service field offering more affordable options for respite care benefiting both caregivers and those with ADRD.
Research of ADS is an emerging topic in the social sciences. Utilizing literature in determining best practices and evaluation methods is considered significantly consequential in the development of quality care as many programs without a strong theoretical base tend to last less than 2 years. To date, most research data is collected by qualitative methods through interviews with caregivers. Substantial attention has been paid to caregivers with respect to results of ADS programming such as change in depression symptoms for care givers and rates of disruptive behavior of family members with ADRD. The past two decades has shown a slight shift in concern to quality of life for participants of ADS, introducing more quantitative data exploring level of engagement by participants, longevity post diagnosis and quality of life indicators.
MCOAD decided to address the growing need for services for ADRD, including ADS which is currently limited in availability in Missoula. This presentation will summarize the results of the coalition’s efforts to address ADS in Missoula, which includes an awareness campaign, current best practices established in the literature and innovations within ADS like intergenerational care and Montessori methods with adults. Through thoughtful planning, MCOAD aims to improve the quality of life for both caregiver and patient alike in the Missoula area.