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Poster Abstracts447. Monitoring Blood Pressure and Tobacco Use in theDental Office – a Pilot Program in 5 Iowa PracticesChristopher Squier, PhD, DSc, FRCPath(Lond), Dept Oral Pathology,College of Dentistry, University of Iowa; Bhagyashree Pendharkar,BDS, MS, School of Public Health, Epidemiology, University of IowaTobacco use is the principal cause of preventable death inthe United States yet 21% of Americans still smoke. One infive Americans has hypertension, which places them at riskfor cardiovascular diseases, contributing to an increase inmortality. Systematic screening by health care professionalscan play an important role in identifying people in need ofprimary prevention strategies for hypertension and in assistingpatients with tobacco cessation, both of which have majorand immediate health benefits. The practice modality of dentalhealth professionals make them particularly suited for briefhealth interventions such as blood pressure (BP) monitoringand referral for tobacco cessation. Our hypothesis was thatscreening and referral for tobacco use and hypertension couldbe simply and effectively carried out in the dental office. Totest this hypothesis we recruited a convenience sample of 5Eastern Iowa dental practices and training was provided forall staff in the offices. The participants completed a pre-testform concerning their behaviors regarding blood pressureand tobacco use screening. Automatic digital blood pressuremonitors, instructions and a protocol to conduct screeningsand to offer quitline fax referral were provided. 1,644 patientsaged 18 years or older were screened at baseline. The meanage of the patients was 44 years and 56% were females. About38% were pre-hypertensive (systolic BP: 121-139) and 16% werehypertensive (systolic BP : 140 or above). Eleven percent werecurrent tobacco users. After 6 months patients were recalledfor screening; among the 648 patients so far assessed wehave found some interesting and important changes frombaseline. In terms of blood pressure measurements therewere increases among patients in knowledge of their BPvalues and in the number seeking treatment; there was also asmall, overall decrease in the proportion of pre-hypertensivesand hypertensives among the population. For tobacco use,there was a slight decrease in the number using tobaccoand an increase in those interested in making quit attempts.Conclusions: The education and tools provided to the dentalpractices enabled them to effectively monitor patients forblood pressure and tobacco use at every appointment.Among the patients screened there was an increase inknowledge of their health status and an increase in seekingassistance from their physician. Research was funded by agrant from the Iowa Department of Public Health ChronicHeart Disease and Stroke Prevention Division [5880HD02].8. * Translating Research into Practice: Assessingthe Adoption of an Interactive Digital Format HIVPrevention by County Health Departments and ClinicsMary Ukuku, MPH, Rollins School of Public Health;Erin Bradley, PhD, Emory UniversityBackground: African American adolescents remaindisproportionally affected by the STI/HIV epidemics. Healthclinics and departments have sought ways to reduce STI/HIV acquisition through various health education venues.Research indicates that group-delivered sexual risk-reductioninterventions decrease STIs. In addition, research has shownthat health related dvds have also been effective healthSOPHE 62nd Annual Meetingeducation tools. Although group-delivered interventions areefficacious, they may not be feasible for all public health clinics.Clinics may not be able to financially support or sustain longterm interventions due to resource or personnel shortages.In contrast, computer-delivered interventions offer a morecost-effective and easily disseminated format. This studyinvestigated the readiness of health departments to adopt aninteractive digital formatted HIV risk-reduction intervention.Theoretical framework: The qualitative component of thecurrent study utilizes the diffusion of innovation. Hypothesisand Methods: Individual interviews were conducted with asubsample of 38 clinical staff and administrators drawn fromseven health department and clinics that service AfricanAmerican adolescents in a Southeastern state. Interviewquestions explored the barriers to adoption, willingness ofthe staff and administrators to integrate the interactive digitalintervention into their clinic flow, and the ability of the clinics/health department to maintain the intervention. Interviewswere 30 minutes in duration, transcribed verbatim, andanalyzed using structured open-coding. The current studywas part of a larger study that adapted an evidence-basedsexual risk-reduction group intervention to an interactivecomputer-delivered format. Results: Administrators andclinical staff indicated that they were receptive to adoptingnew STI/HIV interventions for adolescents and that staffcooperation and compliance were contingent to havinga clear protocol. However, clinical staff stated that lack ofresources and disruption of clinic flow would hinder/impedetheir willingness to adopt an intervention. In addition, inorder for the intervention to be utilized the client’s timeconstraints should be considered. The qualitative data wereused to reformat the digital intervention. Conclusions andimplications for practice: Future researchers should takeinto account the clinic flow, personnel and client restraintswhen developing an interactive computerized healthprogram. Novel interventions are needed that translationresearch to real-world application in a cost-effective way.For health departments and clinics it is important to adoptintervention strategies designed to increase uptake andcompletion that are tailored to the needs of the clinics.9. * The First-Time Motherhood/New ParentsInitiative: Leveraging Social MarketingTechniques to Promote Preconception andInterconception Health Across the LifespanMakeva Rhoden, BS, MPH, CHES, Health Resources and ServicesAdministrationBackground: Through the First-time Motherhood/NewParents Initiative, states created social-marketing campaignsaddressing the topics of preconception/interconceptionhealth, prenatal care, the life course perspective, and newparent education to prevent adverse pregnancy outcomesand promote a healthy first year of life. Campaigns integratedconcepts and recommendations from the Centers for DiseaseControl and Prevention (CDC)/Agency for Toxic Substancesand Disease Registry (ATSDR) Preconception Care Work Groupand the Select Panel on Preconception Care (SPPC). TheoreticalFramework: Techniques of Social Marketing - product, price,place, and promotion - within the public health framework wasused to promote messages on the importance of preparingfor pregnancy.Hypothesis: Using social marketing techniques
Poster Abstractscan increase provider, parent and community knowledge onthe importance of preconception and interconception healthin an effort to reduce adverse pregnancy outcomes.Methods:Funding was provided to 13 states to create public awarenesscampaigns by integrating reproductive health messages intoexisting health promotion campaigns. Formative research inthe form of focus groups was used to obtain information fromtarget audiences on parenting, pregnancy, and knowledgeof pre/interconception health. Logic models were createdshowing expected outcomes of each initiative. Each stateconducted separate evaluations on the effectiveness of usingsocial media and non-traditional campaign techniques (e.g.,social media, PhotoNovella, Digital storytelling, etc.) to increaseawareness of these topics as well. Results: Preliminary resultsof the campaigns indicate: poor understanding of the term“preconception health” prior to start of campaigns; positivereception of social media tools (e.g., Facebook, Twitter, andMySpace) as a discussion forum for topic areas; and importanceof male involvement in discussion. The major limitationsof the study include: absence of a cross-site evaluation tocompare results from focus groups and techniques usedfor campaigns and variations in the level funding providedto each state which may have limited the type of campaignone could implement. Conclusions: Preconception andinterconception health are still considered new topics withinthe maternal and child health discussion forum. More workis needed to create a clear understanding of these conceptsfor consumers and to gain increase acceptance in focusingon preconception health among providers. Implications:Data gathered through campaigns provide a strong casefor moving toward comprehensive systems of care with alife-course focus and create policies which allow healthcareproviders to be compensated for providing services duringthe preconception period for both men and women.10. *The Effectiveness of Alcohol Policiesin 4-Year Public UniversitiesGayle Walter, PhD, MPH, University of DubuqueA problem facing American universities is heavy drinkingby the student body which results in unintentional injuriesand deaths, illegal offenses, sexual assault, altercations, andacademic demise. The relationship between the type ofalcohol policy enacted on campus and alcohol consumptionamong undergraduate students attending 4-year publicuniversities in the Midwestern U.S. was investigated. Thesocial ecological model provided the theoretical foundationfor this study. The social ecological model is the acceptedmodel for heavy drinking on college campuses because itcaptures a broader view of behavior and development inrelation to college students and heavy drinking. A randomsample of students from universities that have policies in placeallowing the sale and use of alcohol in approved locationswas compared to samples of students in universities thathave policies in place prohibiting the sale and use of alcoholon campus. The Core Alcohol and Drug Survey was used toquantify drinking behaviors among students. Multiple logisticregression analysis was used to test the hypothesis that heavydrinking is associated with alcohol policy while adjustingfor the effects of student characteristics. The type of policyin place (wet or dry) was not significant against the odds ofheavy drinking (p = .323) after controlling for age, gender,* Denotes Poster Promenadeethnicity, participation in sports, and participation in Greekorganizations. Gender, age, and participation in sports wereassociated with heavy drinking while participation in Greekorganizations was not. This study provides insight into therelationship of alcohol policy type to heavy drinking. Sincethe results of the study demonstrate that alcohol policy aloneis not effective in reducing the number of students who drinkheavily, an environmental management model is necessary.The five environmental strategies include (a) promoting social,recreational, and public service opportunities to the studentsthat do not include alcohol; (b) forming a social and academicenvironment that encourages and supports healthy behavior;(c) limiting the accessibility of alcohol both off and on campus;(d) restricting the marketing and promotion of alcohol oncampus and during sports-related events. The community canalso support this endeavor by eliminating alcohol promotionsthat include low-priced drink specials and (e) developing andenforcing alcohol policies on campus and local, state, andfederal laws. It also may be beneficial to create an alcoholintervention program targeted to high-risk groups rather thanone universal program encompassing the entire student body.11. *Hospital to Home (H2H): Perfecting Transitionsthrough a Multidisciplinary Approach.Jean Gould, BS, MaineHealth; Mary McDonough, BSN,Maine Medical Partners; Kelly Lemery, BSN, Maine MedicalPartners; Ann Skelton, MD, Maine Medical CenterPurpose: The transition from hospital to home is one of themost problem-prone and costly aspects of medical care in theU.S., costing the Centers for Medicaid and Medicare servicesmore than 102.6 billion dollars. With the Healthcare reformact incorporating pending changes to the reimbursementfor 30-day readmissions structure, the Patient Protection andAffordable Care Act (PPACA) statute will begin to penalizehospitals and integrated delivery systems with higher thanexpected readmission rates. The challenging reasons forreadmission rates have been linked to; misunderstandingmedicines, diagnosis and reason for admission. Additionally,lack of education around managing health problems furthercomplicates patient understanding. Based on the existingdata and the huge financial impact affecting the structure ofthe U.S. health care paying systems, Maine Medical Center’sFamily Medicine practice and the MaineHealth system lookedat how patient education, shared decision making and healthcare provider resources can be used more effectively toimplement system change at the local level. Method: Using amultidisciplinary approach FMC created the Hospital to Home(H2H) concept and team using current resources already withinthe practice. The team is comprised of a social worker, healtheducator, RNs, medical office assistants, residents, attendingphysicians, pharmacist, care manager and translators. Patientsare scheduled to attend the H2H visit the Wednesday afterdischarge. During the visit the patients can speak with anymember of the team. The annual cost of the H2H programis $30,212. Annual gross revenue from H2H visits, based on 4patients, is $30,368 (or $584 per week). Annual cost savingsfrom reduced readmissions is $193,200 Conclusion: Thegoal of the H2H team is to help any patient who has beendischarged from the hospital under Maine Medical Center’sFamily Practice services to better understand their healthissues and medications. This program was created to provideSOPHE 62nd Annual Meeting45
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Poster Abstracts447. Monitoring Blood Pressure and Tobacco Use in theDental Office – a Pilot Program in 5 Iowa PracticesChristopher Squier, PhD, DSc, FRCPath(Lond), Dept Oral Pathology,College of Dentistry, University of Iowa; Bhagyashree Pendharkar,BDS, MS, School of <strong>Public</strong> <strong>Health</strong>, Epidemiology, University of IowaTobacco use is the principal cause of preventable death inthe United States yet 21% of Americans still smoke. One infive Americans has hypertension, which places them at risk<strong>for</strong> cardiovascular diseases, contributing to an increase inmortality. Systematic screening by health care professionalscan play an important role in identifying people in need ofprimary prevention strategies <strong>for</strong> hypertension and in assistingpatients with tobacco cessation, both of which have majorand immediate health benefits. The practice modality of dentalhealth professionals make them particularly suited <strong>for</strong> briefhealth interventions such as blood pressure (BP) monitoringand referral <strong>for</strong> tobacco cessation. Our hypothesis was thatscreening and referral <strong>for</strong> tobacco use and hypertension couldbe simply and effectively carried out in the dental office. Totest this hypothesis we recruited a convenience sample of 5Eastern Iowa dental practices and training was provided <strong>for</strong>all staff in the offices. The participants completed a pre-test<strong>for</strong>m concerning their behaviors regarding blood pressureand tobacco use screening. Automatic digital blood pressuremonitors, instructions and a protocol to conduct screeningsand to offer quitline fax referral were provided. 1,644 patientsaged 18 years or older were screened at baseline. The meanage of the patients was 44 years and 56% were females. About38% were pre-hypertensive (systolic BP: 121-139) and 16% werehypertensive (systolic BP : 140 or above). Eleven percent werecurrent tobacco users. After 6 months patients were recalled<strong>for</strong> screening; among the 648 patients so far assessed wehave found some interesting and important changes frombaseline. In terms of blood pressure measurements therewere increases among patients in knowledge of their BPvalues and in the number seeking treatment; there was also asmall, overall decrease in the proportion of pre-hypertensivesand hypertensives among the population. For tobacco use,there was a slight decrease in the number using tobaccoand an increase in those interested in making quit attempts.Conclusions: The education and tools provided to the dentalpractices enabled them to effectively monitor patients <strong>for</strong>blood pressure and tobacco use at every appointment.Among the patients screened there was an increase inknowledge of their health status and an increase in seekingassistance from their physician. Research was funded by agrant from the Iowa Department of <strong>Public</strong> <strong>Health</strong> ChronicHeart Disease and Stroke Prevention Division [5880HD02].8. * Translating Research into Practice: Assessingthe Adoption of an Interactive Digital Format HIVPrevention by County <strong>Health</strong> Departments and ClinicsMary Ukuku, MPH, Rollins School of <strong>Public</strong> <strong>Health</strong>;Erin Bradley, PhD, Emory UniversityBackground: African American adolescents remaindisproportionally affected by the STI/HIV epidemics. <strong>Health</strong>clinics and departments have sought ways to reduce STI/HIV acquisition through various health education venues.Research indicates that group-delivered sexual risk-reductioninterventions decrease STIs. In addition, research has shownthat health related dvds have also been effective healthSOPHE 62nd Annual Meetingeducation tools. Although group-delivered interventions areefficacious, they may not be feasible <strong>for</strong> all public health clinics.Clinics may not be able to financially support or sustain longterm interventions due to resource or personnel shortages.In contrast, computer-delivered interventions offer a morecost-effective and easily disseminated <strong>for</strong>mat. This studyinvestigated the readiness of health departments to adopt aninteractive digital <strong>for</strong>matted HIV risk-reduction intervention.Theoretical framework: The qualitative component of thecurrent study utilizes the diffusion of innovation. Hypothesisand Methods: Individual interviews were conducted with asubsample of 38 clinical staff and administrators drawn fromseven health department and clinics that service AfricanAmerican adolescents in a Southeastern state. Interviewquestions explored the barriers to adoption, willingness ofthe staff and administrators to integrate the interactive digitalintervention into their clinic flow, and the ability of the clinics/health department to maintain the intervention. Interviewswere 30 minutes in duration, transcribed verbatim, andanalyzed using structured open-coding. The current studywas part of a larger study that adapted an evidence-basedsexual risk-reduction group intervention to an interactivecomputer-delivered <strong>for</strong>mat. Results: Administrators andclinical staff indicated that they were receptive to adoptingnew STI/HIV interventions <strong>for</strong> adolescents and that staffcooperation and compliance were contingent to havinga clear protocol. However, clinical staff stated that lack ofresources and disruption of clinic flow would hinder/impedetheir willingness to adopt an intervention. In addition, inorder <strong>for</strong> the intervention to be utilized the client’s timeconstraints should be considered. The qualitative data wereused to re<strong>for</strong>mat the digital intervention. Conclusions andimplications <strong>for</strong> practice: Future researchers should takeinto account the clinic flow, personnel and client restraintswhen developing an interactive computerized healthprogram. Novel interventions are needed that translationresearch to real-world application in a cost-effective way.For health departments and clinics it is important to adoptintervention strategies designed to increase uptake andcompletion that are tailored to the needs of the clinics.9. * The First-Time Motherhood/New ParentsInitiative: Leveraging Social MarketingTechniques to Promote Preconception andInterconception <strong>Health</strong> Across the LifespanMakeva Rhoden, BS, MPH, CHES, <strong>Health</strong> Resources and ServicesAdministrationBackground: Through the First-time Motherhood/NewParents Initiative, states created social-marketing campaignsaddressing the topics of preconception/interconceptionhealth, prenatal care, the life course perspective, and newparent education to prevent adverse pregnancy outcomesand promote a healthy first year of life. Campaigns integratedconcepts and recommendations from the Centers <strong>for</strong> DiseaseControl and Prevention (CDC)/Agency <strong>for</strong> Toxic Substancesand Disease Registry (ATSDR) Preconception Care Work Groupand the Select Panel on Preconception Care (SPPC). TheoreticalFramework: Techniques of Social Marketing - product, price,place, and promotion - within the public health framework wasused to promote messages on the importance of preparing<strong>for</strong> pregnancy.Hypothesis: Using social marketing techniques
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