• Implementation and Evaluation of a Prescribed Exercise Program Led by a Nurse Practitioner

      Keefer, Leigh Aurora (University of Alaska Anchorage, 2016-12-01)
      Insufficient physical exercise contributes to many disease processes and increases mortality and morbidity rates worldwide. If the world population were to adhere to recommended levels of physical activity, health outcomes would improve. To that end, clinical practices need to consider exercise interventions to improve patient self-efficacy to adhere to recommended physical activity guidelines. A family nurse practitioner led such an intervention in a primary care clinic in Anchorage, Alaska. It evaluated a prescriptive-exercise program using the Exercise is Medicine® (EIM) guidelines of the American College of Sports Medicine. This pilot targeted healthy adults between 18 and 64 years old who were not exercising at least 150 minutes per week. From 20 applicants, eight participants qualified and entered into a 12-week prescribed exercise program. Seven completed the intervention and the subsequent post self-efficacy survey and measurement collection. Measured outcomes were self-efficacy, blood pressure, body mass index and participant’s commitment to follow through with continued exercise. Significant findings from this exercise intervention included (1) increased self-efficacy from “sense of accomplishment”, (2) reduced systolic and diastolic blood pressure and (3) indications that participants would continue physical activity level per recommended guidelines. It is conclusive that implementation of a prescription-exercise guideline in clinical practice can improve the population’s self-efficacy to adhere to the recommended levels of physical activity, and lower blood pressure. Meeting adequate physical activity levels mitigates disease development, improves health outcomes and reduces health care system costs.
    • Implementation of Nudges at a Food Pantry in Anchorage, Alaska

      Holland, Kiana (University of Alaska Anchorage, 2020-12-01)
      Food pantry clients experience many health disparities, including elevated incidence of diabetes, heart disease, and other nutrition-related conditions. Nutrition education interventions in the form of a nudge can be an effective method to increase nutrition knowledge and to positively influence nutrition-related behaviors and attitudes surrounding healthful eating. Attitudes refer to the emotions, or beliefs towards something, whereas behaviors are the actions taken. The goal of this project was to develop a nutrition intervention in the form of a nudge to increase the selection of nutritious foods by pantry clients. Objectives included creating a guidebook for the pantry to utilize when implementing the nutrition education materials that were developed in this project. The nutrition education materials include nudges, extended nudges, client handouts, and recipe cards. This intervention will be implemented at the St. Francis House Food Pantry, which is a part of Catholic Social Services in Anchorage, Alaska. This food pantry serves a broad demographic of clients on a monthly basis, in a client-choice distribution model. The intervention includes nudges, extended nudges, client handouts, recipe cards, and a guide binder. These will be reusable so the pantry can utilize the materials repeatedly in the future. There is limited existing research on implementing nudges in the food pantry setting. Therefore, in order to determine the efficacy of implementing a nudge intervention in Anchorage, Alaska food pantries further research is needed.
    • An Implementation of Remote Alcohol Monitoring in Alaska

      McKelvie, Alan R. (Alaska Justice Statistical Analysis Center, Justice Center, University of Alaska Anchorage, 2005-07)
      The Secure Continuous Remote Alcohol Monitoring (SCRAM) system is an ankle bracelet monitoring device implemented for use in 2003–2005 in Anchorage, Palmer, Fairbanks, Bethel, and Kotzebue. The SCRAM devices monitor the wearers' consumption of alcohol through transdermal analysis. By July 2005 there were 130 units in operation in Alaska, with 202 clients participating in the program in 2003 and 2004, and 176 clients in the first half of 2005, when this evaluation took place. Results showed that the devices functioned effectively in Alaska, including in rural areas (using the Alaska satellite telecommunications network), in extreme cold, and under other inclement conditions.
    • Implementation of Shared Medical Appointments to Address Cardiovascular Disease Risk in Patients With Metabolic Syndrome

      Rife, Jill (University of Alaska Anchorage, 2016-12-01)
      Metabolic syndrome is a condition in which the components – central adiposity, insulin resistance, atherogenic dyslipidemia, and elevated blood pressure - confer increased cardiovascular morbidity and mortality. A pilot clinical practice improvement project was developed and implemented using shared medical appointments to address cardiovascular disease risk in adult patients at a rural health care clinic on the southern Kenai Peninsula, Alaska who met the diagnostic criteria for metabolic syndrome. Statistically significant improvement in self-reported minutes of exercise was demonstrated for the nominal group of participants. Participants were at least as satisfied or more satisfied with shared medical appointments compared to traditional medical appointments. Limitations aside, the Doctor of Nursing Practice (DNP) project demonstrated the feasibility of using shared medical appointments to address cardiovascular disease risk in this patient population. There is need for additional research into the “physiology,” or curricular and other structural and procedural elements of shared medical appointments for patients with metabolic syndrome that would afford decreased cardiovascular disease risk. The Doctor of Nursing Practice (DNP) project goals were in accordance with the overarching aims of the National Quality Strategy that build on the Institute for Healthcare Improvement’s Triple Aim – cost-effective, patient-centered, quality care that improves health.
    • Implementing a State Fiscal Plan: Step 1.Tracking Maximum Sustainable Yield

      Goldsmith, Oliver Scott (Institute of Social and Economic Research, University of Alaska Anchorage, 2013-04-05)
    • Implementing SBIRT in Primary Care: A Study of Three Mat-Su Borough Health Care Practices

      Passini, Jessica; Elkins, Amanda; King, Diane; Frazier, Rosyland (Center for Behavioral Health Research and Services, 2018)
      Despite decades of research evidence that SBIRT is effective for addressing unhealthy patterns of drinking and reducing binge drinking, its adoption within healthcare practices continues to be slow. Providers have identified numerous reasons for not routinely screening and intervening on alcohol, including limited time, training, and resources for patients requiring treatment; lack of confidence in their ability to help patients reduce their drinking; inadequate reimbursement for SBIRT services, and worry about stigmatizing patients.
    • Implications of Oil Supply Uncertainty on a Small Oil-Producing Regional Economy

      Goldsmith, Scott (Institute of Social and Economic Research, University of Alaska., 1994)
      The state of Alaska has an economic and fiscal structure that is unique among the states. The petroleum industry, including exploration and development, production, transportation, and refining, accounts for nearly half of gross state product (the state equivalent of gross domestic product). In theory it is a simple matter to devise a rule that has the dual effects of neutralizing cycles in economic activity associated with the life cycle of petroleum exploitation and maximizing the benefits to residents from the expenditure of the petroleum wealth. Of the many complicating factors that make it difficult to devise and apply such a rule is the uncertainty regarding the size of the endowment, which is also one of the most interesting. How much it is appropriate to spend today depends directly on the size of the endowment not yet collected. This paper reviews a model for answering the public policy question of when to spend, with a special focus on how uncertainty complicates the debate. It also looks at the process of developing a plan for implementing the model within the context of the Alaska political and fiscal structure. Presented at the Second OPEC/Alaska Energy Conference in Anchorage, Alaska on May 7, 1994.
    • Improving Emergency Airway Care at a Critical Access Hospital

      Mitchell, Kelly (University of Alaska Anchorage, 2020-12-01)
      Emergency airway care is of the highest priority in caring for patients arriving at the emergency department with critical injuries and conditions. Intubation via laryngoscopy is the gold standard for placing an endotracheal tube to manage ventilation. In rural areas, emergency airway care is often the responsibility of non-expert providers who rarely have the opportunity to perform this life-saving procedure. These less experienced providers often take a longer time and make more attempts at endotracheal intubation. Multiple attempts and increased time taken to secure an airway are associated with higher morbidity and mortality. A critical review of the literature supports that video laryngoscopy increases first pass endotracheal intubation success. Video laryngoscopy is associated with faster intubation times and an improved view of glottic structures. This evidence-based quality improvement project implemented training and simulation in the use of video laryngoscopy for non-expert providers. After implementation of this quality improvement project, findings demonstrated an improved confidence with use of video laryngoscopy, increased confidence that video laryngoscopy is associated with improved visualization of glottic area and increased confidence associated with first pass of the endotracheal tube in non-expert providers using laryngoscopy to perform endotracheal intubation.
    • Improving Health Care Access for Older Alaskans: What Are the Options?

      Frazier, Rosyland; Foster, Mark A. (Institute of Social and Economic Research, University of Alaska Anchorage, 2010-06)
      This report focuses on the problem older Alaskans who rely on Medicare face getting access to primary care, and discusses some of the options policymakers are considering to resolve the problem. But older Americans across the country also report difficulty getting the primary care they need. The discussion here sheds light on the problem and potential solutions nationwide. Most Americans 65 and older use Medicare as their primary health insurance. Medicare is federal health insurance for people 65 and older, people under 65 with certain disabilities, and people of any age with end-stage renal disease—but this report looks only at access issues for Medicare beneficiaries 65 and older. Doctors don’t have to participate in the Medicare program. But those who do participate have to accept, as full payment, what Medicare pays for specific services. Many primary-care doctors say Medicare doesn’t pay them enough to cover their costs—so growing numbers are declining to see new Medicare patients. Among primary-care doctors nationwide, 61% accept new Medicare patients.1 National surveys sponsored by the Medicare Payment Advisory Commission have found that 17% of Medicare patients in the U.S. had “a big problem” finding family doctors in 2007—up from 13% in 2005.2 In Alaska, a 2008 survey by the Institute of Social and Economic Research (ISER) found that just over half of Alaska’s primary-care doctors were willing to treat new Medicare patients.3 The situation was worse in Anchorage, where 40% of all older Alaskans live. Only 17% of primary-care doctors in Anchorage were willing to treat new Medicare patients as of 2008 (Figure 1).4
    • Improving Teledermatology Utilization in an Alaskan Health Care System

      Rowen, Mary Anne (University of Alaska Anchorage, 2019-05-01)
      The consistent demand for dermatology services, within an Alaskan health care network, warrants an organized, collaborative approach to acquiring a higher capacity of teledermatology consultations. The lack of uniformity among providers for using telemedicine technology in dermatology can hinder cost-saving care. Understanding the obstacles and utilization practices surrounding teledermatology adoption is a crucial objective for a project conducted in an integrated health care system. Devising a protocol with supporting education may reinforce expectations for primary care providers and community health aides and practitioners to be consistent with the utilization of dermatology consultations. A Teledermatology Utilization Project was conducted in an Alaska urban facility to affect change throughout an integrated system. Results indicated a significant increase in teledermatology cases since implementing a protocol and supportive education.
    • In Memoriam [Nancy E. Schafer]

      UAA Justice Center (Justice Center, University of Alaska Anchorage, 2014-02-19)
      Dr. Nancy E. Schafer, a member of the Justice Center faculty from 1983 to 2002, died in September 2013 after an illness. Research publications and papers by Dr. Schafer can be viewed at the Justice Center website.
    • In the Shadow of Boone and Crockett

      Hartman, Ian C. (University of Alaska Anchorage. Bookstore, 2016-02-06)
      In his book In the Shadow of Boone and Crockett: Race, Culture, and the Politics of Representation in the Upland South, Ian Hartman explores American race theories concerning people of the upland South (southern Appalachia to the Ozarks.) While analyzing the southern stereotypes of there being a pure, superior "American race" with those portraying poor, debased, white "imbeciles," Ian Hartman describes how the eugenics movement "sought to regenerate and purify a once proud but now impoverished and degraded people through policies that included forced sterilization." Ian C. Hartman is an assistant professor of History at UAA. He completed his PhD at the University of Illinois at Urbana-Champaign.
    • In-State Gas Demand Study

      Goldsmith, Scott (Institute of Social and Economic Research, University of Alaska Anchorage, 2010-01-01)
    • Increasing Food Safety Compliance With Online Resources

      Novak, Amber Cristina (University of Alaska Anchorage, 2016-05-01)
      Food-borne illness is a top concern for public policy and public health in the U.S., causing nearly 48 million incidents yearly. The number of confirmed food-borne illness outbreaks has declined over recent years as regulation and control measures of the Food and Drug Administration have increased. However, despite increased regulations and decreased outbreaks, there are still a large number of food safety violations, and it is imperative that food service employers continue to encourage good food safety practices. Mandated training has produced varying results on the improved inspection scores of restaurant establishments, but understanding the barriers to food safety and employing food safety intervention measures has had positive results on improving the employees’ food safety compliance behaviors. There is an opportunity to explore new interventions and mediums to increase safe food handling behaviors. This project describes the development of a food safety resource, FoodSafetyKmowledge.org. The site exists as a singular location for managers to find all of the necessary safety and sanitation resources in one accessible and convenient place. The discussion and analysis includes feedback from other food service professionals, and I offer recommendations to improve the site for future use.
    • Increasing Police Utility through Organizational Design

      Angell, John E. (Criminal Justice Center, University of Alaska Anchorage, 1976-11)
      Research by social scientists over the past decade provides strong evidence that American policies concerning police organizational designs have served in many instances to restrict the social usefulness, or utility, of local police operations. Substantial changes in police organizational designs are unlikely to occur unless policymakers have relatively comprehensive and complete models. To satisfy policy officials, a model must be (1) easily understood by laypersons, (2) logically related to definitions of problems acceptable to policymakers, (3) sufficiently defined to provide guidelines for systemic, incremental changes, and (4) adequate to facilitate simple, but accurate, assessment of the impact of changes consistent with the model. This paper is in pursuit of such an alternative model for improving police utility.
    • Index to Volumes 1–10

      UAA Justice Center; Green, Melissa S. (Justice Center, University of Alaska Anchorage, 1994-04-11)
      The Alaska Justice Forum began publication in May 1977 under funding from the Alaska Criminal Justice Planning Agency, Governor's Commission on the Administration of Justice. It was published by the Criminal Justice Center (now the Justice Center) of the University of Alaska Anchorage and was edited by Roger V. Endell, Peter S. Ring, and Paul L. Edscorn. Due to lack of funding it discontinued with the June 1979 issue (Volume 3, Number 6). The Justice Center and the Alaska Justice Statistical Analysis Unit resumed publication of the Alaska Justice Forum under a different format in Spring 1987 (Volume 4, Number 1) with partial funding from the Bureau of Justice Statistics, U.S. Department of Justice. The Alaska Justice Forum is edited by Antonia Moras. This index includes all articles published in the Alaska Justice Forum from Volume 1, Number 1 (May 1977) through Volume 10, Number 4 (Winter 1994). It was compiled by Melissa S. Green.
    • Indigenous elder teachings on science, technology and other issues for the 21st Century

      Merculieff, Larry (University of Alaska Anchorage. Bookstore, 2011-04-19)
      This will be a fascinating look at how the contributions of indigenous knowledge and ways of thinking can benefit people today. Larry Merculieff was born and raised in a traditional upbringing on St. Paul Island. In 2003, Larry was instrumental in gaining both federal and state recognition of Alaska Native subsistence rights to harvest halibut throughout coastal Alaska. Recently he founded Seven Generations Consulting.
    • Indigenous Knowledge Systems and Cross-Cultural Research

      Barnhardt, Ray (2015-03-06)
      The initiatives outlined in this article are intended to advance our understanding of cultural processes as they occur in diverse community contexts, as well as contribute to the further conceptualization, critique, and development of indigenous knowledge systems in their own right. Just as those same initiatives have drawn from the experiences of indigenous peoples from around the world, the organizations and personnel associated with this article have played a lead role in developing the emerging theoretical and evidentiary underpinnings on which the associated research is based. The expansion of the knowledge base that is associated with the interaction between western science and indigenous knowledge systems will contribute to an emerging body of scholarly work regarding the critical role that local observations and indigenous knowledge can play in deepening our understanding of human and ecological processes, particularly in reference to the experiences of indigenous peoples. This article addresses issues of relevance to underserved populations in Alaska and other geographic regions inhabited by indigenous peoples. It provides a much-needed impetus toward organizing research and education support structures that contribute to the broadening of an infrastructure fostering the use of multiple knowledge systems and diverse approaches to research. The international scope of the initiatives described provides multiple benefits derived from the economies of scale associated with linking numerous small-scale populations, as well as increased applicability of outcomes associated with the extensive opportunities for cross-cultural comparison.