Arizona State University

The Health Resources and Services Administration (HRSA) has awarded two three-year grants totaling $2.1 million to the ASU College of Nursing & Healthcare Innovation. The grants bring the college’s funding total from HRSA to $3.7 million since July 2007.

HRSA, part of the U.S. Department of Health and Human Services, is the primary federal agency for improving access to health care services for the uninsured, isolated or medically vulnerable.

In the first grant award, the ASU nursing college received funding from HRSA for “KySS Fellowship for NPs in Underserved U.S.: Improving Child & Teen Mental Health.” The college’s dean, Bernadette Melnyk, is the principal investigator and project director, and Michael Rice and Ann Guthery are co-project directors.

The grant funds the development and implementation of a KySS (Keep your children/yourself Safe and Secure) fellowship program aimed at preparing primary care pediatric and family nurse practitioners, as well as physicians and allied health professionals, to screen for, identify and deliver early evidence-based interventions for children and adolescents experiencing common mental health problems.

The fellowship program, the first of its kind in the United States, is a collaborative effort between the ASU College of Nursing & Healthcare Innovation and the National Association of Pediatric Nurse Practitioners’ (NAPNAP) KySS program, a national initiative that promotes the mental health of children and teens.

The initiative will enhance advanced practice nurses’ knowledge and skills to identify and implement early evidence-based interventions with culturally diverse high-risk children and teens that have common mental health problems in rural and urban settings. The KySS program will provide an Web-based fellowship program that integrates clinical practice experiences in clinical practice settings to provide opportunities for health care providers to put into practice the content from the online educational modules.

One out of every four children and adolescents (about 15 million) in the United States has a mental health problem that interferes with functioning at home or at school. Just 20 percent to 25 percent of these children receive treatment, according to the American Psychological Association. Primary care providers are in a unique position to identify and manage common behavioral and mental health problems among children and teens, since about 75 percent of children with mental health disorders are seen in primary care settings.

Significant health disparities exist in the receipt of mental health services, with a disproportionate number of Hispanic and African-American children affected. A nationwide shortage of 30,000 child psychiatrists contributes to the severe gap in child and adolescent mental health services. In Arizona, the psychiatric physician-to-population ratio is less than the national average, with 134 child psychiatrists practicing in the state in 2004. One-third of the counties in Arizona have no child psychiatrists.

The KySS fellowship program is a continuing education program designed to prepare nurse practitioners, physicians and other health care professionals to identify and implement early evidence-based interventions for children and adolescents with common mental health problems. The KySS fellowship program consists of 20 Web-based modules designed to be completed at the participant’s own pace and will be complemented by clinical learning activities and post-tests. Upon completion of the program, participants will receive a KySS fellowship certificate of completion from the College of Nursing & Healthcare Innovation and the National Association of Pediatric Nurse Practitioners.

The National Association of Pediatric Nurse Practitioners is the only national organization dedicated to improving the quality of health care for infants, children and adolescents and to advancing the pediatric nurse practitioner’s role in providing that care. The association serves almost 7,000 members nationwide.

The second HRSA grant awarded to the College of Nursing & Healthcare Innovation is titled “Leveraging Educational Technology for Evidence-Based Practice.” Its goal is to improve the quality and delivery of nursing education through expanding use of educational technology for pre-licensure students. Debra Hagler is the principal investigator and project director, and Beatrice Kastenbaum and Ruth Brooks are co-investigators.

The Institute of Medicine Roundtable on Evidence-Based Medicine has set a goal for 90 percent of clinical decisions to be supported by the best available evidence by 2020.

This innovative approach expands use of educational technology to promote student learning through dedicated development of faculty expertise, creation of effective instructional design, mentorship for clinical preceptors and collaboration with interdisciplinary partners.

Efforts to address the nursing shortage by increasing student enrollment have led to challenges in contracting enough appropriate clinical learning sites, which affects clinical practice opportunities. The project goal is to employ educational technology simulation for focused learning in conjunction with planned clinical experiences to expand clinical experiences for students while providing culturally responsive, evidence-based clinical decision-making.