Small Evaluation Grants Program

Academic Partner: Emory University, Nell Hodgson Woodruff School of Nursing

Practice Partner: Atlanta Veteran’s Administration Medical Center (AVAMC)

Project Title: Impact Analysis of Leveraging Resources through an Academic Partnership to Serve Homeless Veterans

Principal Investigators: Lisa Muirhead, DNP, APRN, ANP-BC, Assistant Professor; Aimee Manion, DNP, RN-BC, CMSRN, NEA-BC, Associate Nurse Executive and Ken Hepburn, PhD, Professor

Project Description
The AACN/CDC collaborative small grants  project is designed to evaluate the impact of service-learning initiatives created to advance the health of homeless Veterans. Through an existing academic partnership, educational and clinical resources are leveraged to extend and augment services to this vulnerable population through community engagement at the VA Medical Center and an inner city community program for homeless men. A multi-method approach will be employed to evaluate the following outcomes:

1. extent of Veterans’ satisfaction with care provided by nursing students and faculty
2. access and use of health care services at the VA and/or community health centers following the intervention
3. determination of enhanced workforce capacity and cost savings associated with student and faculty involvement
4. impact of the service learning experience on participating students. Data sources will include surveys, records review and quantitative reports

The aim of the project will be to establish the extent of the value associated with health promotion and disease prevention efforts in the context of academic service-learning, inform continued program improvement, and perhaps demonstrate the strength of the partnership in delivering preventive care to homeless Veterans.

Results
The results of the project revealed the following:

• At the community site,  Veteran participants provided high rating on their overall satisfaction of the student led projects.
• Among the 25 Veteran participants, 68% of respondents expressed interest In health promotion activities that would assist them to modify their diet; 32% of Veterans indicated they would like to quit smoking in an effort to improve their health, and 28% indicated an interest in more exercise to improve their health.
• At the annual VA Stand Down event, the greatest impact was  upon participants who had few previous interactions with the VA system.
• Veterans accessed the system 16 more times after the intervention compared to an equivalent period of time prior.
• At the community site, administrative representatives acknowledge that the VANAP team provided educational and health promotion services that may have not been provided to Veterans.
• Students overwhelmingly perceived that both events helped them understand their professional role in promoting health among individuals experiencing homelessness, and highly rated the extent to which the community engagement with homeless Veterans was valuable.
• Nursing students demonstrated  shift in perception (pre-event) of homeless individuals as hopeless and troubled to vulnerable and a sense of need for nursing advocacy (post event).
• Most students indicated an increase in knowledge regarding homeless Veterans.
• Overall, students and faculty extended care and provided a myriad of health screening, immunizations and health education services as all nurses performed during the event, a direct cost savings.

Academic Partner: Indiana University School of Nursing, Bloomington, IN

Practice Partner: Volunteers in Medicine Clinic, Bloomington, IN

Project Title: Impacting Diabetes Risk Factors in the Uninsured Population

Principal Investigator: Deanna Reising, PhD, RN, ACNS-BC, ANEF

Project Description
Indiana University School of Nursing (IUSON) and Volunteers in Medicine (VIM) clinic in Bloomington, IN have partnered in a program to impact Body Mass Index, HgA1C levels, and blood glucose control in a medically underserved and uninsured population with diabetes. Nursing and medical student teams serve as client navigators with VIM professionals to facilitate client participation in exercise programs, engagement in healthy eating strategies, and VIM appointments as methods to improving Healthy People 2020 indicators centered on diabetes management and control. The primary question is: To what extent do student navigator teams create “value-added” to risk modification in the uninsured population with diabetes? The focus of this part of the research is to create a tool, the Behavioral Response Survey (BRS), that will accurately and consistently record both process and outcome indicators of the project. The goal of the of the partnership between IUSON and VIM is to engage in rapid cycle testing of interventions by interprofessional student teams to determine which intervention or intervention-sequences have the most significant impact on the Institute for Healthcare Improvement (IHI) Triple Aim of improving the patient experience of care, improving the health of populations and reducing the cost of health care. Findings from the evaluation will contribute to the National Center for Interprofessional Practice and Education.

Results
In April, 2015, preliminary data was analyzed. Of the eight teams:

• 4/8 clients realized decreases in weight and BMI
• 3/8 clients realized decreases in blood pressure
• 4/8 clients realized decreases in Hgb A1c levels
  • Healthy People 2020 Objective D-5.1 (A1c < 9%) was accomplished for 7/8 clients
  • Healthy People 2020 Objective D-5/2 (A1c < 7%) was accomplished for 4/8 clients
  • Healthy People 2020 Objective D-11 (A1c testing twice a year) was accomplished for 7/8 clients

Academic Partner: Linfield-Good Samaritan School of Nursing

Practice Partners: Rose Haven, Our House, New Beginnings, and Westbrook Housing Association 

Project Title: Impact Evaluation Study

Principal Investigators: Melissa Jones, PhD, RN, CHPN, COI, Associate Professor; Henny Breen, PhD,RN, CNE, COI, Assistant Professor 

Project Description
The RN to BSN Program is an integral part of the Linfield-Good Samaritan School of Nursing (LGSSON). The experiential learning component of the RN to BSN program recently transitioned to a service learning experience in the local or international community. This study addresses a gap in the nursing education literature related to RN to BSN students who complete service-learning experiences at community organizations. Although there is a growing body of evidence related to service learning in pre-licensure programs, very little addresses the impact of service learning on student learning, on the community organization, and the population served when the student is a Registered Nurse completing their bachelor’s degree.

The study is the second part of a series of evaluation studies:

1. a previous qualitative study examines the learning experiences of 51 students who completed service learning in the fall of 2014 at various community organizations,
2. this study will evaluate the impact of service learning on the partner community organization, and
3. a follow-up study will measure the impact on the population being served. The three evaluation studies will form the basis for future program development and service learning experiences that meet the need for student learning, the goals of the community organization, and address healthcare issues in the population.

Results

Impact of RN to BSN Service Learning on the Community Organizations
The primary themes that emerged in the data that reflected the impact of RN to BSN service learning on the community organizations included:

1. Increased access to health services and support for the population served.
2. Improved involvement of the community members in health activities due to the credibility and qualifications of the RN to BSN student.
3. Enhanced the quality of care and services as a result of the recommendations provided by the RN to BSN student.

Impact of Service Learning Experience on RN to BSN Student Learning
The primary themes that emerged in the data that reflected the impact of the service learning experience on RN to BSN student learning included:

1. Increased awareness of the struggles faced by vulnerable populations. 
2. Improved communication skills with members of the community.
3. Deeper understanding of the needs of vulnerable populations through reflecting on their experiences.  

Academic Partner: Millikin University School of Nursing

Practice Partner: Crossing Health Care

Project Title: A Connection for Detection and Health

Principal Investigators: Jo Carter, RN, EdD, Associate Professor

Project Description
An important element of health professions education rests upon helping students recognize the challenges in our nation’s health as opportunities for innovation. In addition, millennials are known for their proficient use of social tools. This evidence-based project capitalizes on these two synergies. It requires that nursing students, in collaboration with faculty and agency staff, explore data related to health behavior indicators reported by the Youth Risk Behavior Surveillance System, the Behavioral Risk Factor Surveillance System, the Robert Woods Johnson Population Health Institute, as well as other health center, community and state-wide databases. Students and staff will generate, review and analyze these data to consider the center’s and community’s performance on health behaviors and other measures of health. Using tutorials and information links offered by the Centers for Disease Control and Prevention, student teams will collaboratively design novel social media campaigns aimed at improving health behaviors, health literacy, and the health outcomes of Crossing’s enrolled population. Students will identify client segments, craft developmentally targeted messaging, and create copy using a variety of digital and other formats.

Academic Partner: Northern Kentucky University Nurse Advocacy Center

Practice Partner: Northern Kentucky Health Department

Project Title: Nursing Advocacy Center for the Underserved: Assessing the Impact

Principal Investigators: Adrianne Lane, EdD; Kristine Pfendt, MSN, RN, Associate Professor 

Project Description
The purpose of this project is to evaluate the impact of the academic/practice partnership between Northern Kentucky University Nurse Advocacy Center (NACU) and the Northern Kentucky Health Department on building health capacity. One of the priorities in achieving improvements in population health is aimed at reducing health disparities in certain groups. This evaluation projects will benefit the public health community by demonstrating the effectiveness of an academic/practice partnership aimed at addressing health needs in underserved populations.

The key objectives of this project will be to:

1. design a comprehensive evaluation plan based on the logic model,
2. collect and analyze data for identified strategies within the plan, and
3. determine the next steps for NACU operations including delivery of care, evaluation, advocacy, and sustainability, and
4. dissemination of knowledge gained. Results of the impact evaluation will provide a basis for the NACU to further its mission to improve health of the underserved. Dissemination of the results will foster similar initiatives for other academic/practice partnerships to address population health via creating similar academic/practice partnerships to address the health care disparities among the underserved. 

Results
The results are presented per key objective.

1. Design a comprehensive evaluation plan based on the logic model. The plan was developed with the input of the NACU and Northern Kentucky Independent Health Department. The NACU patient registration form was revised using input from stakeholders concerning key elements that would demonstrate impact on the regional health goals. The revised form was piloted. Healthcare personnel reported no concerns with the revised form. The revised form was adapted by the NACU.  The NACU patient registration form was the basis for completing the impact assessment check-sheet. This check-sheet will be completed for each NACU site on an annual basis (see below). Summary as well as per NACU site check-sheet data will be shared with the Northern Kentucky Independent Health Department on an annual basis at an academic/practice partnership collaborative meeting. The impact of NACU will be demonstrated through the data and the data will serve as a foundation for future planning.
2. Collect and analyze data for identified strategies within the plan.
   Data was collected at 5 of the identified 8 NACU sites including Welcome House of Northern Kentucky, Ida Spence United Methodist Mission, Madison Avenue Christian Church, Brighton Recovery Center for Women, and the Emergency Shelter of Northern Kentucky.  Transitions, WRAP, and the Women’s Crisis Center were no longer NACU sites during this grant period; thus no data was collected at these three sites.  Even so, data was collected at all current NACU sites.
   
   Although data on numerous variables were collected, the following are keenly representative of the NACU patient population.
   
   2016: n=232
   84.1% female
   34.4% under 30; 42.1% are 30-50; 23.4% over 50
   87.7% White; 9.1% Black; 0.5% Hispanic; 2.7% Other
   9.0% uninsured
   18.1% job
   73.9% High School/GED
   
   2015: n=130
   85.8% female
   44.9% under 30; 31.4% are 30-50; 23.7% over 50
   83.8% White; 7.7% Black; 0.8% Hispanic; 7.7% Other
   8.8% uninsured
   18.7% job
   70.2% High School/GED
   
   2012: n=57 (Does not include Madison Avenue Christian Church)
   59.7% female
   28.1% under 30; 56.1% are 30-50; 15.8% over 50
   66.1% White; 26.8% Black; 3.6% Hispanic; 3.6% Other
   61.8% uninsured
   51.5% job; 48.5% government assistance
   57.1% High School/GED
   
   2016: 2015----Variables of Significance
   Barriers to Care:  None <0.0001 and Transportation <0.0001 (Barriers have increased, however transportation is less of a barrier)
       Living Arrangements <0.0001     More living in rehab
       Tobacco <0.0001     More smoking 10 or more cigarettes per day
   
   Recreational Drugs  <0.0001 (heroin, meth, cocaine, marijuana, opiates, crack, Xanax, )
   
   Less use overall
   
   Drinks <0.0042    More indicating no drinking
   
   2015: 2012----Variables of Significance
   Ethnicity is different (<0.0031)   More reporting white with fewer indicating black, Hispanic
   
   Uninsured (<0.0001)   More reporting having insurance
   
   Gender (<0.0001) More responding female
   
   Stakeholder data was collected via focus groups with Northern Kentucky Independent Health Department (NKYHD) personnel and NACU personnel. Among the various areas identified as useful for measuring impact on regional health by the NKYHD were the perception of health as well as Hepatitis C status. This data was incorporated into the development of the service-related check-sheet. Identified variables included age, sex, ethnicity, insured status, income, living arrangements, alcohol use, tobacco use, recreational drug use, occupation, education level, vaccination history, medical history including Hepatitis C, mental health diagnosis, and pain management, barriers to care, perceived health status, referrals, and number of visits to site per year.
   
   Satisfaction data was collected from NKU faculty, NKU students, volunteers, and site partners. This data revealed that the experience in provided services through NACU was rated as good (10%) to very good (50%) to excellent (40%) for the faculty, volunteers and site partners and good (15%) to very good (23%) to excellent (42%) for the students. Comments from the students included that more time should be planned for students to participate more fully at the NACU sites.
   
   Service-related results using a check-sheet format was collected at each site in February. The check-sheet was evaluated as reasonable and informative by the NACU director.  The check-sheet serves as the code book for data entry of the variables found on the revised patient registration form. The revised patient registration form informed via the focus groups was implemented in February 2016 without concerns or comments from the NACU site personnel. The NKYHD leadership expressed support of the impact assessment via the check-sheet data.
   
   
3. Determine the next steps for NACU including delivery of care, partnerships with NKYHD and other community agencies, evaluation, advocacy, and sustainability. The next steps include assuring the revised patient registration form is implemented at each NACU site and that the previous form is removed. A timeline for the completion of the impact assessment check-sheet must be developed for each NACU site. An annual academic/practice partnership collaborative meeting must be scheduled to share and act on the impact assessment. This shared data will serve as a basis for evaluation, advocacy, and sustainability. Use of the impact assessment check-sheet will become a regular part of the operations at each NACU site.
4. Dissemination of knowledge gained. The results of the impact assessment check-sheet will be shared with the NACU Board at their annual meeting. After this presentation, a meeting will be scheduled with the Northern Kentucky Independent Health Department to share the NACU impact assessment for the 2015-2016 academic year. Patient data related to this impact assessment development process will not be shared outside of NACU and the Northern Kentucky Independent Health Department. The process for developing an impact assessment will be shared through professional presentation and publication.  

Academic Partner: Texas Christian University

Practice Partners: Mansfield Independent School District, Tarrant County Public Health, and City of Arlington

Project Title: Impact Evaluation of the Safe Routes to School Partnership

Principal investigator: Danielle Walker MSN, RN, CNE, Professor

Project Description
Texas Christian University initiated a partnership in 2008 with Mansfield Independent School District (MISD) and Tarrant County Public Health (TCPH) to develop a Safe Routes to School (SRTS) program that would foster healthy physical activity for students and their families. The program’s goal was to increase student walking and bicycling (referred to as Active School Transport [AST]) to school through building a physical and cultural environment that was safe and accessible. The purpose of this impact evaluation project is to answer 3 research questions:

1. What is the effect over time of increasing Active School Transport awareness in the community?
2. How did the Safe Routes to School program impact the built environment?
3. What is the community’s perception of the Safe Routes to School program? What is the impact of the program on the community? What is the impact of the program on Active School Transport?

Researchers will use a variety of tools including surveys, evaluations, and focus groups to collect data. The program will employ senior BSN nursing students in public health practicums to conduct the research activities proposed. Findings from the study will assist in determining the effectiveness of the SRTS program and will help determine the continuation, design, and implementation of future SRTS partnerships in Tarrant County.

Results
The built environment was assessed using a walkability study and a civil engineer. 

• 265 parents of elementary aged children participated in the Safe Routes to School Parent Survey
• 12 participants joined focus group discussions on community perceptions of SRTS 
  • Survey results indicated that safety while walking and biking was not a major concern (drop from 2007)
• Survey/Focus group results indicated that Parents were more concerned with the construction, sidewalks, traffic, and distance to and from school (increase from 2007)
• Survey/Focus group results indicated that Parents would be more willing to allow their children to bike or walk to school if the sidewalks were further improved
• Survey/Focus group results indicated that the current built environment did not address many of the parent’s concerns. Even though the program created sidewalks there were many issues with the area that prevented parents from engaging in walking/biking with their children
• Survey/Focus group results indicated that some of the remaining issues included: narrow sidewalks (4ft.), lack of traffic signage, lack of bike lanes
• Survey/Focus group materials highlighting survey results and current safety issues where presented to Mansfield Independent School District and school administrators

One of the notable accomplishments of this evaluation project is the use of thirty BSN students (three public health practicum sections) to develop and conduct the research. For maximum efficiency and learning outcomes each group of students focused on an individual research question. One such group conducted the built environment survey and walkability study. During this process these students worked closely with a Civil Engineer whose specialty is Safe Routes to School and the walkability of communities. This partnership led to an increased understanding of the social determinants of health and allowed student to learn and apply strategies for change to the built environment. This new and unexpectedly successful partnership has led to the development of other public health practicum projects and negotiations have also begun to write a paper about interdisciplinary partnerships between civil engineering and public health nursing.

Academic Partner: University of Arkansas for Medical Sciences, School of Nursing

Practice Partner: Hospitals in the State of Arkansas

Project Title: Impact of Academic-Practice Partnership using mHealth Technology on Heart Failure Benchmarks with Older Adults in Rural and Medically Underserved Areas of Arkansas

Principal Investigators: Leanne L. Lefler, PhD, ACNS-BC, APRN, FAHA;  Associate Professor

Project Description
The Aims of the mHealth Initiative: To examine the perspectives of older adult patients with heart failure on remote patient monitoring in relation to 1) patient satisfaction and 2) patient perspectives on healthcare team communication and engagement, 3) feasibility, and 4) value.

Question 1: Do patients in the remote monitoring [mobile health (mHealth)] group report higher levels of patient satisfaction compared to the standard of care and/or non-remote monitoring group?

Hypothesis 1: Patients who are being monitored remotely by the mHealth monitoring will express greater levels of satisfaction due to their increased contact/communication with the healthcare provider team.

Question 2: Do patients in the remote monitoring group report better healthcare team communication and engagement compared to the standard of care and/or non-remote monitoring group?

As part of this proposal, UAMS will develop an Impact Evaluation Survey tool to further measure and compare important indices of their mHealth program:

Hypothesis 2: Patients in the remote monitoring group will report better communication and engagement in his or her heart failure management.

Question 3: Is it feasible for older adults to use technology for heart failure management in their homes?

Hypothesis 3: Patients who are remotely monitored using the technology will perceive the technology to be easy to use.

Question 4: Do patients in the remote monitoring group perceive the technology as beneficial to his/her chronic disease management?

Hypothesis 4: Patients who are remotely monitored using the technology will perceive the technology as beneficial in his or her chronic disease management.

Question 5: What are the barriers and facilitators of using technology to provide remote patient monitoring of the older adult.

1. National HF Benchmarks for each participant:
   a. Hospital & Provider visits, including previous hospital admissions and readmissions for HF compared to hospital and Provider visits during our mHealth program per designated group.
   b. Adverse events, morbidity, mortality (per designated group)
   c. Other national quality indicators: discharge instructions (if hospitalized); evaluation of LV function recorded, angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) prescribed. (per designated group)
2. Patient symptoms, complaints, or improvement in symptoms or complaints (per designated group)
3. Improvement or decline of indices of HF to include: Activities of daily living ADLs, diet adherence (sodium intake), physical activity, BP, weight. (per designated group)

Academic Partner: University of Buffalo, School of Nursing

Practice Partner: Catholic Health System's Sisters of Charity Hospital

Project Title: Evaluation of the Safe Sleep Baby Video App for Population Health Education

Principal Investigators: Deborah Raines PhD, EdS, RN, ANEF,  Associate Professor

Project Description
This partnership developed the Safe Sleep Baby video as a mechanism to spread evidence-based knowledge and behaviors among the population involved in caring for newborns in our community. The Safe Sleep Baby video empowers mothers to inform other about the safe positions and environments for the infant during sleep, and can dispel traditional practices and myths about how infants are positioned and where they are sleeping.

This project will evaluate the impact of a community/public health teaching intervention initiated during the post-birth hospitalization and extended into the community. Specifically, this project will implement a longitudinal evaluation of the effectiveness and dissemination of the Safe Sleep Baby video. The specific questions to be answers are:

• Is an educational video accessible on a personal technology device an effective mode to inform the population about safe sleep positions and environments for newborns?
• Do mothers share an educational video accessible on a personal technology device with extended family members and caregivers?
• Does an educational video accessible on a personal technology device change the perceptions and behaviors of others (not the mother) about safe sleep positions and environments for newborns?

This population based intervention is designed to empower new mothers to share evidence-based practices about safe sleep positions and environments for infants with everyone who interacts with and cares for their infant. The goal is to disseminate current and scientifically based information to all individuals involved with infant care and to keep infants safe during sleep.

Academic Partner: University of Nebraska Medical Center College of Nursing and College of Public Health Service Learning Academy

Practice Partner: Douglas County Department of Corrections and Douglas County Health Department 

Project Title: Evaluating the Impact of an Academic-Practice Partnership on an Epidemic:  The DojuSTIce Program

Principal Investigator: Katherine Kaiser, PhD, ADN, BSN, MSN

Project Description
DojuSTIce is the name of an academic-practice partnership between University of Nebraska Medical Center (UNMC) College of Nursing and College of Public Health Service Learning Academy, Douglas County Department of Corrections (Omaha, Nebraska) and Douglas County Health Department (local health department). The focus of the partnership is to reduce chlamydia and gonorrhea rates which are at epidemic levels in the county by education and screening interventions for the inmates at the department of corrections. The goals of the partnership are to:

1. make an impact on the STI epidemic by engaging with jail inmates through education, screening and treatment, and
2. prepare health professions students to intervene inter-professionally with underserved populations, such as the jail inmates, enhance cultural awareness and communication skills with the population, learn clinical competence regarding sexual health, learn leadership and community engagement.

The partnership was launched in 2008. The program protocol consists of an inmate OPT-IN voluntary screening and STI education on Saturday mornings and follow-up treatment of positive persons on Thursday evenings by students under faculty supervision. Frequency is dependent on student volunteers but average about once or twice a month consistently. To date, over 300 students have made more than 100 visits to the jail, providing education to over 8,000 inmates, and testing over 3,200 inmates.

Results
Trends in these data show increasing testing at DCDC and subsequent increases in positives as more are tested. This is most likely due to an increase in the trust that had been established with the jail population over time by those implementing the program and also the jail staff. The positive STI numbers indicate that testing, educating and treating the jail population is good public health due to population and behavioral risk factors. In addition, the qualitative data from the student journals indicated that the students felt that the inmates were very attentive and asked many appropriate questions during the STI education program that is provided before urine samples are obtained. Several concluded that the education was a very important element in the effort to reduce the epidemic.

The impact evaluation provides important support and benefits for the DojuSTIce program in Douglas County, Nebraska. The programs targets a population who is high risk for STIs. It also provides education for those who may not have ever received it before, or if they did not attend to it as they could in this setting.

Overall these data and analyses demonstrate the positive impact the DojuSTIce service-learning program has had on student skills and attitudes about outreach to the community to serve populations, making a difference in doing so, dispelling stereotypes about populations, and their appreciation of the inter-professional team. They also gained useful practice skills in communication, decision-making, and teaching. They became more confident in their abilities as health professionals and gained appreciation of the inter-professional team.

Academic Partner: University of North Florida School of Nursing

Practice Partner: Community Health Outreach, Inc.

Small Grant Title: Development of Student and Faculty Instruments to Measure Impact of the UNF Home-base Model Community Service-Learning Curriculum

Principal Investigator: Barbara J. Kruger, PhD, MPH, RN, Associate Professor and Edessa C. Jobli, MD, MPH, Evaluation Specialist

Project Description
The purpose of this project is to refine, psychometrically test, and pilot five data collection instruments to measure impact of service-learning among students and faculty. The impact evaluation is guided by a Logic Model developed by faculty, students, and community partners. Data collection instruments have been drafted after extensive review of the literature. Students, faculty, and community partners will rank survey items and rate item relevance, clarity, and understandability. Data collection tools will then be pilot tested with faculty and students. Instruments include quantitative and qualitative measures:

1. student satisfaction with service-learning/clinical courses,
2. student satisfaction with community agency partner,
3. student learning outcomes (health promotion, nursing role, determinants of health, partnering, and knowledge of community),
4. faculty-partner assessment of readiness to partner, and
5. faculty outcome assessment. Five additional instruments have been identified to measure processes and outcomes among partners and clients and will be developed and tested at a later time with eventual application to a comprehensive impact evaluation across all stakeholders.

Results
This study produced valid and reliable instruments to measure process and outcome of community-based nursing service-learning.

1. Faculty Assessment of Community Partner Resources Survey
2. Faculty Assessment of Service Learning Outcomes Survey
3. Community Nursing Student Assessment Scale (CNSAS ver.2) of Learning Outcomes
4. Student Satisfaction with Service Learning Survey
5. Student Satisfaction with Community Partner

This study also tested the feasibility of collecting data from already very busy nursing students and faculty. It was interesting to find that although students are technologically very astute the response rate to the surveys improved dramatically when we approached them with paper surveys in the classroom. Due to feedback from some students about their already overburdened schedules a decision was made to forgo the planned focus group and instead include brief answer questions on the survey. Combining two of the student surveys (Satisfaction with SL and Partner) into one survey form was also done to decrease respondent burden with potentially three surveys. As it was, students were confused about which survey they had completed when only doing two of them for this study. Students in the classroom indicated they are asked for all type of evaluations that it is difficult to keep them straight. Faculty meanwhile were very responsive with the exception that they sometimes forgot their unique identifier PIN number. They were asked to choose a 4 digit number and remember it. In the future, perhaps suggesting that faculty use the last 4 digits of their cell or office phone number might be helpful. Students meanwhile were asked to use their student ID number and had not trouble with recall.

A discussion of the results of faculty and student survey results will be drafted more comprehensively for publication. Overall, student and faculty response to service-learning in this program demonstrated satisfaction and positive learning outcomes / growth. The lack of statistically significant improvement in the pre and post student and faculty outcome surveys are likely due to the very short time [3-4 month span] between data collection times. UNF SON's prior experience with the CNSAS is that improvement is quantifiable and significant between the first and third semester and between the third and fifth semester. Future data collection will incorporate a longitudinal approach of a longer span of time. Sub-analyses are also planned and are likely to demonstrate a relationship between type of experience / placement and student satisfaction and learning.

As indicated in the grant proposal, specific results and instruments will be shared through publication and will be used by this institution in a subsequent three-year study. This AACN grant has provided a scaffold for UNF SON's success in obtaining funding through an (internal) three- year University Professorship Grant to complete development of the partner and client instruments, conduct a four month pilot study using all ten questionnaires, and expand to a 12 month study that would include multiple faculty, students, partners, and clients. UNF SON would also like to partner with other schools of nursing who express interest in evaluating their service-learning programs and are considering a multi-site proposal for the future.

Click here for program description.

Academic Partner: University of Portland School of Nursing

Practice Partner: Village Gardens

Project Title: Exploring the Impact of a Community-Academic Partnership Project

Principal Investigators: Barb Braband, EdD, RN, CNE, Associate Professor; Kala Mayer, Phd, RN, Assistant Professor

Project Description
A community-academic partnership was established in 2011 to explore how one academic nursing program and a non-profit community organization could work together to make a difference in the health of community residents through collaboration, health promotion, and skill-building. The partnering university is a private, faith-based university located in a major U.S. city in the Pacific Northwest. The university is located in close proximity to a dynamic and innovative non-profit community food organization situated in an urban, multi-generational housing project. The residential community underwent a transformational process through federal Hope VI grant funding from 2001-2010 resulting in the demolition of the existing neighborhood housing project and the rebuilding and renaming of the housing community. The purpose of this study is to understand the value of the community-academic partnership and how it could be improved over time. The study will examine the impact of participation in the project on:

1. building a collaborative relationship between partners;
2. enhancing student community health skills; and
3. meeting the community's health promotion needs. Community-academic partnerships can be an effective strategy to address a community’s complex health concerns. Knowledge gained will assist in building partnership capacity for effective community outreach and health promotion.

Results
Outcomes related to the project evaluation goals included the following components:

1. Building a collaborative relationship between the New Columbia community and the University of Portland, School of Nursing.
   Findings revealed a partnership relationship characterized by coordination at the conclusion of this evaluation project. A range of relationship characteristics included working toward a shared goal, shared leadership, shared resources, teamwork, and an opportunity for enhanced collaboration were noted (Mattessich, P. W., Murray-Close, M., & Monsey, B. R., 2001).
   
   
2. Enhancing student community health skills.
   Results from the evaluation related to student skill building revealed curriculum successes based on the outcomes and strong data in this area, with some areas for improvement. Positive learning outcomes in enhancing student skills in many areas of public health competencies were achieved including outreach, screening, referral, health teaching, collaboration, community organizing, and social marketing (Minnesota Department of Health, 2001).
   
   
3. Meeting the community's health promotion needs.
   Findings revealed significant room for improvement in measuring and enhancing community health promotion outcomes. Limited data collection for this outcome was noted. Primary health promotion behaviors impacted through this partnership included healthier eating, cooking skills, exercise skills, stress management skills, increased blood pressure monitoring, openness to learning and change, increased connection to providers, and improved health curriculum in schools (Nutbeam, 1996).
   
   In addition to the primary partner, Village Gardens, the project also included the evaluation of partnership outcomes with new community partners established since the 2014 fall semester in New Columbia including Home Forward (Housing) and Portland Parks and Recreation Department (Charles Jordan Community Center, Elementary After School Child Program). A partnership with Kitchen Commons was initiated in the 2015 spring semester.

Academic Partner: Villanova University, College of Nursing

Practice Partner: Nationalities Service Center

Project Title: Screening and Health Access for Immigrants in Philadelphia: Impact Evaluation Project

Principal Investigators: Ruth McDermott-Levy, Associate Professor & Director, Center for Global & Public Health

Project Description
Since 2010, Nationalities Service Center (NSC) and the Villanova University College of Nursing have partnered to improve health access for immigrant populations in the Philadelphia region. In June 2015, NSC implemented the Health Access Program (HAP). HAP seeks to expand the availability of NSC's health services to all clients. HAP Provides NSC clients health screening and education, and support in accessing care including health insurance enrollment and referrals to primary care.

Most recently, NSC has included VU undergraduate nursing students in assessing client health access needs. Under this initiative, VU proposed to further evaluate the success of their joint pilot HAP in order to grow and improve the program to meet the health access needs of this underserved population. Beginning June 2016, Villanova undergraduate nursing students, with faculty and NSC staff supervision, began providing health screening and health education, and collaborating with NSC staff in health insurance enrollment and primary care referrals.

There were two components of this project. The first was to provide health screening for immigrants who come to the  NSC in Philadelphia for resettlement assistance. Health screening included assessment of current health problems and blood pressure, blood sugar, BMI, and vision as well as assessment of health access (health education, health insurance, and health providers).

The second component was to enhance undergraduate public health nursing student educational experience by providing a service learning opportunity embedded in a didactic required nursing course, Imperatives for Global & Public Health. Student learning was measured by evaluating self-efficacy in working with immigrant populations. Self-efficacy was measured twice; the first time, before the nursing students participated in immigrant screening, and the second time, after they participated in the screening. Self-efficacy was measured using a 20-question survey, which is a modified version of Scale Assessing Self-Efficacy for Cultural Competence in Immigrant Health (Assemi et al., 2006). 

Results

1. 51 undergraduate nursing students participated in the immigrant/refugee health screening. (Goal 50 students)
2. Of the 51 nursing students, 40 nursing students completed the pre-screening Scale Assessing Self-Efficacy for Cultural Competence in Immigrant Health. (Goal 50 students).
3. At the time of this report, 20 students have completed the post-screening Scale Assessing Self-Efficacy for Cultural Competence in Immigrant Health. (Goal 50 students).

Nursing students have verbalized positive responses to participating in immigrant health screening. They have shared that they have gained an appreciation of the challenges for immigrant clients in accessing health and the ability to work with an interpreter or the language phone line. Villanova will begin to analyze the data from pre and post Scale Assessing Self-Efficacy for Cultural Competence in Immigrant Health tool once all post-screening surveys are collected. This will be by the end of the semester the current academic semester (May 2017).

Meeting the intended goals of the number of immigrants served has been a greater challenge. At the completion of this program there were:

1. 63 immigrants and refugees screened in the project. (Goal: 150)
2. 45 immigrants and refugees have received health education information and materials related to their health needs. (Goal:150)
3. 14 of the immigrants and refugees screened needed and were referred to health care providers including ophthalmologist, dentist, and medical examination. (Goal: 125)
4. 21 immigrants required referrals within Nationalities Services Center for assistance with enrolling in a health insurance program (Goal: 80)

The targeted goal of 150 immigrants screened and supported in health education and access was not met. At the NSC, the advertisement was changed to include signs in English, French, and Arabic to market the health-screening program. Also, trusted NSC volunteers and employees in recruited participants and reached out to other departments within the organization to inform them about the program and program goals. This program took place while U.S. federal policy was changing regarding immigrants and refugees entering the U.S. The people who use the NSC services were concerned about their legal status in the U.S. They visited the agency for legal immigration services. Health screenings were neither a priority nor an interest for many who were concerned about their immigration status. It was found that many NSC clients were concerned that they would miss an important legal appointment if they took time for health screening.