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Excellence in Nursing Education
The overall goal of my research program is to promote health behavior change and address health disparities for individuals in culturally, ethnically, or racially distinct groups. My particular research interests include risk perception and communication related to type 2 diabetes prevention, health disparities associated with type 2 diabetes risk among individuals in rural areas, and increasing access to the National Diabetes Prevention Program (DPP). Type 2 diabetes is a significant public health problem in the United States, with 10.5% of the population diagnosed and over 34.5% of adults at increased risk (Centers for Disease Control and Prevention [CDC], 2020). In addition, approximately 5-10% of at-risk individuals will develop type 2 diabetes without lifestyle modifications (Tabak et al., 2012). As such, type 2 diabetes prevention is an important public health concern and requires innovative approaches to prevention intervention delivery. Diabetes prevention is especially important in rural areas because of higher rates of obesity and limited access to risk reduction resources (Rural Health Information Hub, 2022). Although the prevalence of type 2 diabetes in Wyoming (9%) is lower than the national average (10.5%), rates are rising (Wyoming Department of Health, 2021). In Wyoming, type 2 diabetes increased from 3.7% in 1994 to 7.8% in 2014 and to 8.3% in 2016 (CDC, 2018a; Wyoming Department of Health, 2018). Contributing to the increase in type 2 diabetes diagnoses is the estimation that 35.2% of adults in Wyoming have prediabetes; that is, increased risk due to higher than normal blood glucose levels (CDC, 2018b). Increasing access and support for the DPP in Wyoming is important for decreasing the rising rates of type 2 diabetes. Research examining the impact of the DPP indicates that people at-risk for type 2 diabetes who reduce their body weight (5-7%) by making modest changes, reduce their risk of developing the disease by about 58% (DPP Research Group, 2009). Through my research on understanding perceptions of type 2 diabetes risk, I learned about the barriers to and facilitators of risk reduction activities. To address both as well as move my research forward, I focused on programming and intervention work and embarked upon two projects. The goal of the first project was to create
Christie Wildcat, a Northern Arapaho student from Riverton, WY, is a cross-country runner and works out with teammates in the High Altitude Performance Facility. Rael Otuya, from Kenya, at the ACRES student-ran farm on campus. Rael is studying agroecokogy and sustainable agriculture in the College of Agriculture and Natural Resources. After college she hopes to travel back to her home in Kenya and help farmers there take up sustainable practices and provide more food with less resources to their people.
a student facilitator training program and learn about at-risk individual acceptance of students as facilitators. In collaboration with Bhibha Das PhD (East Carolina University) and members of my student research team (Strategies for Risk Reduction Lab), we created and implemented the training program and conducted focus groups with at-risk individuals. We presented this work at the Society of Behavioral Medicine Annual meeting (April 2022) and Fay W. Whitney School of Nursing Research and Scholarship Day (April 2022). We are currently working on a manuscript for publication and a conference abstract. The goal of the second project was to learn more about diabetes prevention in Wyoming and understand ways to address limited access to prevention programs. Through a collaboration with the Wyoming Department of Health, University of Wyoming College of Health Sciences, and Maggie Kougl of the UW Wyoming Center on Aging (regional coordinator), we developed a university-based DPP which began in February 2022. In addition, we met with state and university stakeholders to share ideas about current and future prevention programming collaborations. Our DPP sessions are currently in progress. University of Wyoming students, staff, and faculty were invited to join the DPP. Maggie Kougl and I, both certified DPP lifestyle coaches, facilitate group sessions where participants learn the skills needed to reduce their risk, such as losing a modest amount of weight through changes to activity levels and nutrition. Participants in the program learn how to eat healthy, add physical activity to their routine, manage stress, stay motivated, and solve problems that can affect their lifestyle change efforts. The group format provides a supportive environment for individuals who are facing similar challenges and trying to make the same changes. Participants receive encouragement from the lifestyle coaches and each other. The DPP meets for one year; weekly for the first six months, then once a month for the second six months. For the UW DPP, we plan to present or publish our experience conducting the program on a rural university campus as well as expand our programming to the community. In addition, a Doctor of Nursing Practice (DNP) student is conducting their quality improvement project with our DPP (fall 2022-spring 2023). The project goal is to implement and evaluate strategies, such as motivational tools, reminders, or social interactions, that improve participant engagement during the final six months of the program. This is especially important due to the reduced number of group meetings and contact with fellow group members. Finally, we expect our program to achieve CDC recognition, which will allow us to expand our programming, and are exploring the ways in which UW can serve as a support network for DPPs throughout the state. We are enthusiastic about our current DPP and optimistic about the future of DPPs in Wyoming.
Jenifer Thomas, PhD
References:
Centers for Disease Control and Prevention (CDC). (2018a). Diagnosed diabetes. Retrieved from https://gis.cdc.gov/grasp/diabetes/diabetesatlas.html
Centers for Disease Control and Prevention (CDC). (2018b). Chronic disease indicators, Wyoming. Retrieved from https://nccd.cdc.gov/cdi/rdPage. aspx?rdReport=DPH_CDI.ExploreByLocation&rdRequestForwardi ng=Form
Centers for Disease Control and Prevention (CDC). (2020). National diabetes statistics report, 2020. Retrieved from https://www.cdc.gov/diabetes/data/ statistics/statistics-report.html
Diabetes Prevention Program Research Group. (2009). 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet, 374, 1677-1686. Rural Health Information Hub. (2022). Why diabetes is a concern for rural communities. Retrieved from https://www.ruralhealthinfo.org/toolkits/ diabetes/1/rural-concerns
Tabak, A., Herder, C., Rathmann, W., Brunner, E., & Kivimaki, M. (2012). Prediabetes: A high risk state for diabetes development. Lancet, 379, 2279-2290.
Wyoming Department of Health. (2018). Wyoming behavior risk factor surveillance system, 2016 data. Retrieved from https://health.wyo.gov/publichealth/ chronic-disease-and-maternal-child-health-epidemiology-unit/ wyoming-behavior-risk-factor-surveillance-system-2/brfss-data2/2016-data/
Wyoming Department of Health. (2021). Chronic disease prevention program: Wyoming statistics. Retrieved from https://health.wyo.gov/publichealth/ prevention/chronicdisease/data/
EXCELLENCE IN NURSING EDUCATION
BUILDING A PROGRAM OF RESEARCH
Rebecca Carron, PhD, RN, NP-C American Indians/Alaska Natives (AIANs) suffer from many health disparities including type 2 diabetes and decreased access to health care. Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects all women across all ethnicities with a prevalence of roughly 10-15%. Various hormone imbalances cause women with PCOS to have both fertility issues and an increased risk for type 2 diabetes. Researchers have demonstrated that PCOS symptoms and the symptoms that matter most to women with PCOS vary across ethnicities. Unfortunately, knowledge about PCOS in AIANs is very limited. My main research work in the FWWSON focuses on understanding PCOS in AIANs. I have conducted two recent studies examining the following: 1) symptoms and problems from PCOS in AIANs, and 2) prevalence of PCOS in AIAN women. My results indicated that women AIAN women suffer from many of the common problems of PCOS with weight management a main issue of concern. The study participants also indicated they would like more culturally appropriate information about PCOS, more community information about PCOS, and, finally, they would like to be diagnosed sooner. These results are helping me to continue to build a program of research to help improve health care outcomes for AIAN women with PCOS. I am also grateful to past and present members of my research team for their assistance!
References:
Carron, R., Kooienga, S., Gilman-Kehrer, E., Alvero, R., & Boyle, D. K. (2019). Using the medicine wheel to study polycystic ovary syndrome in American Indian women. Research and Theory for Nursing Practice: An International Journal, 33(3), 246-256. http:// dx.doi.org/10.1891/1541.6577.33.3.246 Carron, R., Kooienga, S., Gilman-Kehrer, E., & Alvero, R. (2019). Cultural experiences, patterns, and practices of American Indian women with polycystic ovary syndrome: An ethnonursing study. Journal of Transcultural Nursing,31(2), 162-170. https://doi. org/10.1177/1043659619856670
Views along the Wind River Canyon in central Wyoming. The Wind River cuts through the expansive canyon as it meanders through the Wind River Indian Reservation and Hot Springs County.
James Trosper is Northern Arapaho and Eastern Shoshone. He is a descendant of Chief Washakie and Chief Friday. Trosper is director of UW’s High Plains American Indian Research Institute (HPAIRI), promoting positive and productive relationships between UW and regional Native American communities.
EXCELLENCE IN NURSING EDUCATION
PARTNERING FOR SUCCESS
The future of nursing education is the Academic Practice Partnership. The University of Wyoming has a collaborative Academic Practice Partnership with Cheyenne Regional Medical Center. This role is an important mechanism to strengthen nursing practice. This role facilitates evidence-based practices, addresses current trends in nursing education and the future needs of the nursing workforce in real time, and streamlines clinical education and academic progression. Working with both the University and CRMC allows us to see nursing needs from academia to the transition to professional practice and beyond with continuing education for licensed nurses. Over the last two years a valuable and mutually beneficial relationship has been established. As we emerge from COVID-19, the nursing workforce needs for are very complex. We continue to work on increasing the staff at CRMC to 80% Bachelor prepared nurses through encouragement of the nurse residents to continue or enroll in the ReNEW BSN completion program at UW. This work continues despite ongoing nursing staffing difficulties encountered during the pandemic. Following the pandemic pause on the Accelerated BSN or BRAND program through UW, the program began a new cohort this fall with new clinical placement at Cheyenne Regional. We continue to recruit new and interested educators and faculty members to continue their education in the UW MSN program to educate the next generation of nurses needed to fill the gaps in nursing caused by an increasing number of patients, significant amounts of nurse retirement and employment shifts from the pandemic. There is a continued effort in partnership with both institutions to improve clinical education at CRMC and to prepare a workforce for the demands of the profession while off-loading the demands of the current nursing staff to decrease staff burnout. At Cheyenne Regional Medical Center, having a research faculty promotes scholarship. At the time of this article, I have done consultations with five CRMC staff, both
Niki Eisenmann PhD, RN Clinical Assistant Professor Fay W. Whitney School of Nursing Academic Practice Partner Cheyenne Regional Medical Center
nursing and interprofessional staff to publish work in peer-reviewed journals. I am hopeful that as in-person conferences are coming back to have nurses and our residency projects represent CRMC and present their work to their colleagues on a national level. Part of a successful academic practice partnership is working with the transition to practice of new graduate nurses through the nurse residency program. Understanding and using evidence to support practice is an important skill of all nurses, and all nurse residents are required to do a project asking a practice question and evaluating current literature related to the question. I work closely with the nurse residents to assist with their projects and some residency projects go further than presenting to stakeholders on their unit. One recent project started by nurse residents went to full implementation. Instead of assessment of pain using a severity scale (0-10), the use of a functional pain scale was explored. Further research was done regarding patient and nurse satisfaction and with positive results, a pilot of the assessment scale was done on one nursing unit at CRMC. With positive outcomes of nursing staff in using the new pain assessment, the new pain scale was adopted to the whole hospital this summer. Working to implement evidence-based practices is done with the help of the staff nurses who after successfully piloting the pain assessment scale, taught all the courses as the assessment was implemented hospital wide. Quality improvement and implementation of best practices are components of evidence-based practice facilitated by the academic practice partnership. There are other projects in various stages of research and implementation, including rounding best practices, fall prevention practices, and work with the electronic health record.
