• Alaska's Economy: Then and Now

      Guettabi, Mouhcine (Institute of Social and Economic Research, University of Alaska Anchorage, 2017-10-11)
    • Alaska's Fiscal & Economic Outlook

      Guettabi, Mouhcine (Institute of Social and Economic Research, University of Alaska Anchorage, 2019-04-16)
    • Alaska's System for Monitoring Compliance with the Juvenile Justice and Delinquency Prevention Act

      Parry, David L. (Justice Center, University of Alaska Anchorage, 1988-12)
      Pursuant to Section 223(1)(15) of the Juvenile Justice and Delinquency Prevention Act of 1974 and 28 CFR Part 31.303(f), states are required to describe their plans and procedures for annually monitoring compliance with the Act. Alaska's monitoring plan was developed by the Justice Center of the University of Alaska Anchorage in 1988 under contract with the Alaska Division of Family and Youth Services (DFYS).
    • Alaska's System for Monitoring Compliance with the Juvenile Justice and Delinquency Prevention Act (Revised)

      Schafer, N. E. (Justice Center, University of Alaska Anchorage, 1994-08)
      Pursuant to Section 223(1)(15) of the Juvenile Justice and Delinquency Prevention Act of 1974 and 28 CFR Part 31.303(f), states are required to describe their plans and procedures for annually monitoring compliance with the Act. This revision of Alaska's monitoring plan revises the plan originally developed by the Justice Center of the University of Alaska Anchorage in 1988 under contract with the Alaska Division of Family and Youth Services (DFYS).
    • Alternative Certification: A Research Brief

      Hirshberg, Diane (Center for Alaska Education Policy Research, University of Alaska Anchorage, 2011-10-01)
      Alternative teacher certification (ATC) encompasses a broad range of programs that prepare teachers in non-traditional, accelerated ways (Suell and Piotrowski 2007). The number of teachers prepared through alternative routes has increased considerably in the past decade. As of 2011, 16% of public school teachers nationwide had entered the profession through some kind of alternative program, and in the last five years, 40% of new hires have come through ATC programs (Feistritzer 2011). In this brief I offer a short overview of research on the outcomes of alternative certification programs compared with traditional certification, summarize findings about what makes for effective alternative certification programs, and describe ATC programs in Alaska. Generally, ATC programs are aimed at people who are interested in becoming teachers and have at least a bachelor’s degree, as well as extensive life experience. But how these programs are defined and what they include varies considerably (Humphrey and Wechsler 2007). In this brief, alternative certification is defined as a program in which teacher candidates work as the instructor of record while completing their teacher certification. These programs are considered to be both a means of alleviating teacher shortages and a way of improving the quality of the teaching workforce. In addition to shortening the preparation time and being more flexible for working participants, ATC programs also typically incorporate mentoring (Mikulecky, Shkodriani et al. 2004; Scribner and Heinen 2009). The programs range from initiatives run by school districts and state departments of education to university-operated efforts run alongside traditional teacher preparation programs (Yao and Williams 2010).
    • Assessment of Services Available for Children Exposed to Intimate Partner Violence in Anchorage, Alaska

      Vadapalli, Diwakar (Institute of Social and Economic Research, University of Alaska Anchorage, 2015-09-01)
      The Cook Inlet Tribal Council (CITC) plans to expand services provided under its Flourishing Child initiative, and requested an assessment of service needs for children in the Anchorage area that are exposed to intimate partner violence (IPV). Specifically, CITC wishes to know if the proposed expansion of Flourishing Child services will satisfy an unmet need in the community. This assessment includes a brief introduction and review of related concepts, and an assessment of services available within the Municipality of Anchorage.
    • Attitudes towards land use and development in the Mat-Su: Empirical evidence on economic values of ecosystem services

      Schwörer, Tobias (Institute of Social and Economic Research, University of Alaska Anchorage, 2014-04-25)
      In communities that largely depend on the extraction of natural resources, attitudes towards conservation and development may seem at odds or particularly rigid. With an unprecedented wealth of natural capital, a growing mining sector, strong oil and gas industry, and a politically conservative population, Alaska serves as a case study to measure such attitudes. This research was motivated by a lack of primary ecosystem service valuation studies in Alaska that could be used to assess the public’s perceived value of ecosystem services in order to guide future land use decisions and incentivize land use decisions that minimize negative externalities. A choice experiment was conducted with 224 households in the Matanuska-Susitna Borough, the fastest growing region in Alaska and one of the fastest growing regions in the U.S. Rapid development with few restrictions has led to changes for local ecosystems particularly important to salmon, negative effects on access related to recreation and tourism, and caused conversion of valuable farmland. Study results show that attitudes and values vary regarding future land use and economic development efforts. On average, policy action to improve conditions for local salmon stocks are most valuable to local residents followed by protecting farm and ranch lands as well as public access to recreation sites. Conversely, residents show negative preferences towards rapid population growth and developing local mining, oil and gas, and timber resources but support developing a professional and technical services sector. The quantified welfare changes related to different development scenarios show that focusing on conserving valuable ecosystem services is in the public’s best interest.
    • Baseline Assessment: Alaska's Capacity and Infrastructure for Prescription Opioid Misuse Prevention

      Elkins, Amanda; Barnett, Jodi; Hanson, Bridget; Smith, Oliver (Center for Behavioral Health Research & Services, University of Alaska Anchorage, 2017-08-01)
      The State of Alaska Department of Health and Social Services (DHSS), Division of Behavioral Health (DBH) was awarded the Partnerships for Success (PFS) grant by the Substance Abuse and Mental Health Services Administration (SAHMSA) in 2015. DBH contracted with the Center for Behavioral Health Research and Services (CBHRS) at the University of Alaska Anchorage (UAA) to conduct a comprehensive project evaluation. As part of the evaluation, CBHRS performed a baseline assessment of the state’s capacity and infrastructure related to prescription opioid misuse prevention. Researchers conducted interviews with key stakeholders representing state government, healthcare agencies, law enforcement, substance abuse research, and service agencies. Interviews were semistructured, with questions addressing five domains of interest: (1) state climate and prevention efforts; (2) partnerships and coordinated efforts; (3) policies, practices, and laws; (4) data and data monitoring; and (5) knowledge and readiness. Thirteen interviews were conducted and analyzed using a qualitative template analysis technique combined with a SWOT analysis (i.e. strengths, weaknesses, opportunities, and threats). Emergent themes are displayed in Table 1 below. Table 1. Emergent themes from SWOT analysis Strengths Weaknesses Opportunities Threats (1) New and revised policies and guidelines (2) Activities and partnerships between state agencies and communities (3) Knowledge and awareness of state leadership (1) State policy limitations (2) Insufficient detox, treatment, and recovery support resources (3) Lack of full coordination within state agencies and with communities (1) Education enrichment (2) Policy improvements (3) Expansion of treatment, recovery, and mental health support (1) State fiscal crisis (2) Prescribing practices (3) Complexity and stigma of addiction (4) Legislative support Despite limitations in sample representativeness and interview timing, participants agreed that agencies, communities, and organizations across Alaska have demonstrated great concern about the opioid epidemic and that this concern has translated into considerable efforts to address and prevent opioid misuse. Participants also noted a variety of opportunities as targets for future work, many of which would address some of the current weaknesses that exist. Results yielded clear recommendations for increasing awareness and providing education to a variety of groups, further improving relevant policies to promote prevention, and expanding services for prevention and treatment.
    • Baseline Opioid Survey: Access, Consumption, Consequences, and Perceptions among Young Adults in Alaska

      Barnett, Jodi; Hanson, Bridget; Smith, Oliver (Center for Behavioral Health Research & Services, University of Alaska Anchorage, 2017-05-01)
      In September of 2015, SAMHSA awarded the Partnerships for Success (PFS) grant to the State of Alaska  Department of Health and Social Services, Division of Behavioral Health (DBH). The PFS grant program is  a five‐year effort that focuses on preventing and reducing substance use and building prevention  capacity at both the state and community levels. DBH provides leadership for the project and facilitates  the conduct of project activities by community‐level coalitions. Additionally, DBH contracted with the  Center for Behavioral Health Research and Services (CBHRS) at the University of Alaska Anchorage (UAA)  to conduct a comprehensive evaluation of the PFS project.   Using a data‐informed prioritization process to narrow the substance abuse focus of the grant, the State  Epidemiological Outcomes Workgroup chose two PFS priority areas: 1) non‐medical use of prescription  opioids among 12‐25 year olds; and 2) heroin use among 18‐25 year olds. Data on the use of and  consequences related to prescription opioids and heroin in Alaska are described below.  Partnerships for Success (PFS) Priority Area: Non‐Medical Use of Prescription Opioids  Data from the National Survey on Drug Use and Health (NSDUH) indicate that young adults aged 18‐25  consistently have the highest percentage of non‐medical use of prescription pain relievers in Alaska  compared to youth aged 12‐17 and adults aged 26 and older (see Figure 1).1,2,3 While small decreases in  use were observed among all age groups from 2009 to 2014, the age‐specific pattern remained  consistent.   Figure 1. Past year non‐medical use of prescription pain relievers in Alaska from 2009 to 2014 by age  Additional data requested from NSDUH (see Table 1) indicated no significant change in non‐medical use  of prescription pain reliever estimates among 12‐25 year olds in Alaska between years 2007‐2010 and  2011‐2014 but a decreasing trend was observed for past year use and past year prescription pain  reliever dependence or abuse.4 0 5 10 15 2009-2010 2011-2012 2013-2014 Percentage 12-17 years 18-25 years 26+ years 4 Table 1. Past year non‐medical use of prescription pain reliever estimates among individuals aged 12  to 25 in Alaska from 2007 to 2014  1 Dependence/abuse is based on definitions found in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM‐IV)  Estimates of past year non‐medical use of prescription pain relievers among individuals aged 12 and  older in Alaska are slightly higher than national estimates but both follow a small decreasing trend in use  from 2009 to 2014 (see Figure 2).1,2,3 Figure 2. Past year non‐medical use of prescription pain relievers among individuals aged 12 and older in  the U.S. and Alaska from 2009 to 2014  Other indicators related to non‐medical use of prescription opioids in Alaska have also decreased slightly  or stabilized in recent years. Treatment admissions for synthetic opiates (opiates or synthetics including  Methadone, Oxycodone, or Oxycontin) as a primary, secondary, or tertiary substance of abuse have  stayed relatively stable from 2013 to 2015 (1,052 to 1,011 treatment admissions), according to the  Alaska Automated Information Management System (AKAIMS).5  Age‐adjusted overdose death rates in  Alaska have decreased from 11.2 per 100,000 in 2009 to 8.5 per 100,000 in 2015. Although overdose  deaths from prescription opioids are decreasing, Alaska still has higher rates of overdose deaths from  prescription opioids than the nation overall (7.3 vs. 5.1 per 100,000 in 2012).6 
    • Benefits and Costs to Rural Alaska Households from a Carbon Fee and Dividend Program - Final Report

      Colt, Steve (Institute of Social and Economic Research, University of Alaska Anchorage, 2015-08-01)
      This paper analyzes the benefits and costs of a carbon fee‐and‐dividend (CFD) policy to individual rural Alaska households. The three study area regions are the Bethel Census Area, the Kusilvak Census Area, and the Northwest Arctic Borough. These three regions have the state’s highest fuel prices and very cold climates. The CFD policy consists of two elements.  The first is a fee of $15 per metric ton of CO2 beginning in 2016 and increasing by $10 per ton in each subsequent year. The second is the complete return of all fees to households in the form of dividends, which are estimated to equal $300 for each adult plus $150 for each child (up to two). The annual dividends would increase in future years commensurate with the nationwide total amount of fees. Baseline conditions.  The study area has a total population of about 32,000 people, many of whom live in large households with low cash income. Fuel prices averaged $6.62 per gallon in January 2015.
    • COMMFISH: all about Alaska's commercial fisheries collections

      Carle, Daria O.; Kazzimir, Edward; Rozen, Celia M. (IAMSLIC, 2009-07)
      One of the more unique holdings in the Alaska Resources Library and Information Services (ARLIS) stands out due to its extensive size and breadth—the CommFish collection. The entire management history related to Alaska's commercial fisheries is documented here, including controversies over fishing rights, subsistence, and much more. These reports, including primary source data reported nowhere else, precede statehood and capture in great detail the extent, scope, successes, failures, policy decisions, and inventories of Alaska's fisheries statewide. When statehood was realized in 1959, the agency responsible for managing commercial fisheries was also established: the Alaska Department of Fish and Game (ADF&G). Fishery managers in the newly created agency recognized early on that much of the data compiled would be of professional interest, while other information clearly had a public right-to-know component. As a result, a diverse number of series to meet each of these information needs was initially established. Over time, however, these series have been subject to the familiar vagaries common to all gray literature, such as title changes, name irregularities, and murky bureaucratic authorship. ARLIS inherited these extensive collections from several ADF&G libraries over a period of years. Most of the items had never been distributed outside of the agency, and ARLIS often owns the only copy. Recently, ARLIS has spent much time and effort to provide original cataloging for these materials in OCLC. ARLIS’ approach to cataloging these complex series may also be of interest to librarians facing similar challenges.
    • The Cost of Teacher Turnover in Alaska

      DeFeo, Dayna Jean; Tran, Trang; Hirshberg, Diane; Cope, Dale; Cravez, Pamela (Center for Alaska Education Policy Research, University of Alaska Anchorage, 2017-03-31)
      Low teacher retention - high turnover - affects student learning. Teacher recruitment and retention are challenging issues in Alaska. Rates vary considerably from district to district and year to year, but between 2004 and 2014, district-level teacher turnover in rural Alaska averaged 20%, and about a dozen districts experienced annual turnover rates higher than 30%. High turnover rates in rural Alaska are often attributed to remoteness and a lack of amenities (including healthcare and transportation); teachers who move to these communities face additional challenges including finding adequate housing and adjusting to a new and unfamiliar culture and environment. Though urban districts have lower teacher turnover rates, they also have challenges with teacher recruitment and retention, particularly in hard-to-fill positions (such as special education and secondary mathematics) and in difficult-to-staff schools. Annually, Alaskan school districts hire about 1,000 teachers (500-600 are hired by its five largest districts), while Alaska’s teacher preparation programs graduate only around 200. The costs associated with teacher turnover in Alaska are considerable, but have never been systematically calculated,1 and this study emerged from interests among Alaska education researchers, policymakers, and stakeholders to better understand these costs. Using data collected from administrators in 37 of Alaska’s 54 districts, we describe teacher turnover and the costs associated with it in four key categories: separation, recruitment, hiring, and induction and training. Our calculations find that the total average cost of teacher turnover is $20,431.08 per teacher. Extrapolating this to Alaska’s 2008-2012 turnover data, this constitutes a cost to school districts of approximately $20 million per year. We focused on costs to Alaskan school districts, rather than costs to individual communities, schools, or the state. Our calculation is a conservative estimate, and reflects typical teacher turnover circumstances - retirement, leaving the profession, or moving to a new school district. We did not include unusual circumstances, such as mid-year departures or terminations. Our cost estimate includes costs of separation, recruitment, hiring, and orientation and training, and excludes the significant costs of teacher productivity and teacher preparation. We suggest that not all turnover is bad, nor are all turnover costs; and emphasize the need to focus on teacher retention as a goal, rather than reducing turnover costs. Even with conservative estimates, teacher turnover is a significant strain on districts’ personnel and resources, and in an era of shrinking budgets, teacher turnover diverts resources from teaching and learning to administrative processes of filling teacher vacancies. Our recommendations include: • Better track teacher turnover costs • Explore how to reduce teacher turnover costs • Support ongoing research around teacher turnover and its associated costs • Explore conditions driving high teacher turnover, and how to address them
    • Describing the Patient Care Experience: Quality Improvment in Federally Qualified Health Centers in Alaska

      Cooke, Shawna (University of Alaska Anchorage, 2017-05-01)
      The purpose of this quality improvement project was to evaluate whether the quality assurance/performance improvement (QAPI) plan at a federally qualified health center (FQHC) provided a valid mechanism for assessing the overall patient experience or if implementing a multimodal approach to evaluating the patient experience provided a more accurate depiction on which to base operational decisions. The project used the Plan-Do-Study-Act (PDSA) framework to examine the efficacy of a multimodal approach to assessment of the patient care experience. The aims were to describe the patient care experience in a FQHC located in a small community in Alaska using a qualitative descriptive approach; and to examine the qualitative findings in relation to those derived from the aggregate FQHC survey data in order to make recommendations for a sustainable approach to evaluating the patient care experience in this FQHC environment. Provider relationships greatly influenced satisfaction and the perception of care. Participants long for a community clinic connection, to feel valued and connected to the FQHC and the community. Participants were satisfied with interagency coordination and communication, but struggled with understanding the inner workings of the health care system within the community. Participants were eager for community-based opportunities for learning and engagement. The results derived from the focus groups added important information in describing the patient care experience, supported the premise that a qualitative descriptive approach would add additional information not previously derived from the quantitative data, provided an opportunity to engage the community, and elicited a more accurate depiction of the care experience.
    • Determinants of Obesity in Latinos in Anchorage Alaska

      Appa, Andrea (University of Alaska Anchorage, 2015-12-01)
      Determinants of obesity can be complex and group specific. There is limited data about the Latino population and the health needs of Latinos in the state of Alaska. The goal of this project was to better understand the determinants of obesity in Latinos, including the impact of dietary choices, financial status, mental health, and exercising in the levels of obesity of Latinos. The investigator used Statistical Package for the Social Sciences (SPSS) to study the association of several variables in the Behavioral Risk Factor Surveillance System (BRFSS). After data exploration, univariate analysis and logistical regression were conducted for selected variables related to the causes of obesity in Latinos living in the state of Alaska where the investigator observed higher percentages of obesity in Latinos as compared to other groups. However, results were not statistically significant except for the higher percentages with high blood pressure in obese Latinos when compared to non-obese Latinos and other groups. The results produced by this study are evidence that further research is needed to determine the impact of obesity in Latinos and their differences with other groups.
    • Determinants of Obesity in Latinos in Anchorage, Alaska: Analysis of BRFSS Alaska Data, 2007-2013

      Appa, Andrea (University of Alaska Anchorage, 2016-05-01)
      Determinants of obesity can be complex and group specific. There is limited data about the Latino population and the health needs of Latinos in the state of Alaska. The goal of this project was to better understand the determinants of obesity in Latinos, including the impact of dietary choices, financial status, mental health, and exercising in the levels of obesity of Latinos. The investigator used Statistical Package for the Social Sciences (SPSS) to study the association of several variables in the Behavioral Risk Factor Surveillance System (BRFSS). After data exploration, univariate analysis and logistical regression were conducted for selected variables related to the causes of obesity in Latinos living in the state of Alaska where the investigator observed higher percentages of obesity in Latinos as compared to other groups. However, results were not statistically significant except for the higher percentages with high blood pressure in obese Latinos when compared to non-obese Latinos and other groups. The results produced by this study are evidence that further research is needed to determine the impact of obesity in Latinos and their differences with other groups
    • The Determinants of Small Business Success in Alaska: A Focus on the Creative Class

      Guettabi, Mouhcine (International Economic Development Council, 2014-12-01)
      Although the contribution of small businesses and entrepreneurship to regional communities and the economy at large is widely supported in the literature, there does not seem to be a universally accepted definition for small businesses and entrepreneurship. Without an agreed upon definition, it is challenging for governments and policy makers to address the needs, concerns, and issues of these firms. It also makes it difficult to understand the link between small businesses and economic growth.
    • Determinants of the Cost of Electricity Service in PCE Eligible Communities

      Foster, Mark; Townsend, Ralph (Institute of Social and Economic Research, University of Alaska Anchorage, 2017-01-20)
      This report is one of two companion reports ISER prepared for the Alaska Energy Authority. The other report, “True Cost of Electricity in Rural Alaska and True Cost of Bulk Fuel in Rural Alaska,” is dated October 26, 2016. That report estimates the full costs of providing electricity in rural Alaska, including the costs of subsidies provided to lower the price consumers pay. This second report assesses how the costs of electric generation in Power Cost Equalization (PCE) communities are or might be affected by three factors that are not related to the differences in electricity generation costs. Those three factors are the organizational structures of utilities, postage stamp rate design, and managerial information available on energy subsidy programs. 1. Organizational Structures of Utilities Electric utilities in PCE communities are organized as cooperatives, are run by local villages and municipalities, or are investor-owned utilities. The scale of these utilities varies widely, and includes regional utilities that manage separate electric grids in multiple communities. A review of those organizational structures indicates that: 1.1. There are significant differences in distribution, customer service, and general and administrative costs (DCG&A) across utilities. These differences are correlated with the utility size and organizational structure, with the smallest utilities having significantly higher DCG&A costs per kWh. 1.2. Small local utilities that have merged with larger regional utilities have benefited from reduced costs and professional management. Incentives to encourage small local utilities to join larger, more efficient regional utilities should be considered. 1.3. The cost of borrowing for large local and regional electric coops remains low compared with that for stand-alone local villages, municipalities, and investor-owned utilities. 1.4. The state government should consider allowing a return on equity as an allowable expense within the PCE cost of service [AS 42.45.110(a)] to enable utilities to build equity, enhance debt coverage and facilitate the expanded use of private capital, and reduce dependency on limited public capital resources. This private capital may take the form of investor capital for investor-owned utilities or member capital for cooperatives. 2. Postage Stamp Rate Designs 2.1. Postage stamp rate designs—a single rate for electricity for some set of customers—can help reduce costs and improve affordability in smaller, remote communities through an implicit cost subsidization from customers in larger communities. 4 2.2. The subsidies in postage stamp rates may decrease incentives for utilities to manage their costs, because higher costs may be subsidized by postage stamp rate-making. 2.3. The increase in cost in subsidy-providing communities risks inefficient bypass by large commercial or government users. This could increase the total cost of electric service and leave the remaining customers with higher rates and diminished affordability. Separating communities into rate groups according to their cost structure may mitigate, but not eliminate, the risk of self-generators bypassing the local electric utility. 3. Efficiency in Governance of Energy Subsidy Systems 3.1. To assess whether the PCE program is achieving its goals, transparent information about the allocation of the subsidies and about the operation of the subsidized utilities is required. The companion report to this one identified some issues about reliability of information generated under the current reporting system. Improvements in the reporting requirements could address these issues. A common issue is inconsistency in accounting for capital that state and federal agencies contribute to utilities. Those capital contributions include both grants or low-interest loans to finance capital projects as well as sources of short-term government financing, such as annual fuel loans, emergency loans, and write-offs of operating loans for troubled utilities. If capital investments for generation were separated from other capital, investments to reduce fuel costs (such as wind power) could be assessed more directly. 3.2. The PCE program is one of several programs that subsidize energy costs in rural Alaska, and an understanding of the interaction among these programs is required. An annual compilation of all state and federal heating and electrical subsidy support systems by community would enable better understanding of both individual program impact and also the collective programmatic impact of the subsidies on energy affordability. 3.3. Information on system reliability, usually measured as outage hours, is required to fully assess utility performance. 3.4. Currently, there is no information on how well the PCE program and other energy subsidy programs in rural Alaska target families and communities that face the greatest energy affordability challenges. Because of limitations on income data in small rural Alaska communities, assessing how well subsidies are targeted may be challenging. However, in light of general information that energy subsidies are often inefficient at poverty reduction, this is an important question. 3.5. The environmental impact of energy subsidies for rural Alaska, including the PCE program, through CO2 emissions and PM 2.5 emissions, has not been assessed.
    • Development of a Crystalline Silica Management Plan for a Coal-Fired Power Plant

      Martinson, Tracey A. (University of Alaska Anchorage, 2016-05-01)
      Respirable crystalline silica is a serious occupational health hazard. Exposure can result in the development of silicosis, lung cancer, renal disease, and autoimmune disease. Development of silica-related diseases may take 5-40 years, and there is no cure. The U.S. Occupational Safety and Health Administration (OSHA) recognizes the health burden placed on workers exposed to respirable crystalline silica, and has promulgated a regulatory standard that will protect these workers to a greater extent than in the past. The standard mandates that businesses implement exposure monitoring, engineering and work practice controls to reduce exposures, and training and medical surveillance for employees exposed at the action level (AL) for more than 30 days per year. For this project, a brief epidemiological and knowledge assessment of employees was conducted and initial exposure monitoring for workers was performed. Based on the results, recommendations on work practice controls to reduce exposures were made. To comply with the new OSHA standard, a training program for employees was developed, and requirements for medical surveillance were outlined. The results of this work were used to develop a comprehensive Respirable Crystalline Silica Management Plan for the Golden Valley Electric Association power plant located in Healy, Alaska.
    • Diabetes and Nutrition Education for Pregnant Women With Preexisting Diabetes in Urban Alaska: A Retrospective Quality Improvement Study

      Anderson, Audrey (University of Alaska Anchorage, 2020-05-01)
      There has been a rise in the number of women entering pregnancy with preexisting type 1 and type 2 diabetes due to changing demographics of the obstetric population, including advanced maternal age and obesity. Uncontrolled diabetes during pregnancy is directly correlated with adverse perinatal outcomes. Educational approaches need to be taken to decrease the advancement of an intergenerational cycle of diabetes fueling the current global epidemic. This retrospective chart review aimed to evaluate the relationships between completion of education (i.e., diabetes or nutrition) and outcomes measures (i.e., glycemic control and birth outcomes) in mothers with preexisting diabetes at an urban Alaska health system for the purpose of quality improvement in clinical practice. Education provided by a registered dietitian nutritionist and/or certified diabetes educator in accordance with the American Diabetes Association Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes – 2020 improves clinical outcomes, behaviors, and quality of life. In this study, data from 78 charts were reviewed including BMI, HbA1c preconceptionally and during each trimester, pregnancy complications (i.e., preeclampsia), birth outcomes (i.e., gestational age, birth weight, cesarean delivery, shoulder dystocia, malpresentation, premature rupture of membrane, postpartum hemorrhaging, and fetal loss), demographics (i.e., age, employment status, ethnicity), and completion of diabetes education or nutrition education. The insufficient availability of outcome measures documented in medical charts and low numbers of medical record sharing among facilities limited the ability to evaluate the impact of education on glycemic control and subsequent birth outcomes in this study. The systematic evaluation of outcomes is the backbone to demonstrating the efficacy of registered dietitian nutritionists and certified diabetes educators in helping women achieve glycemic self-management outcomes. In terms of quality improvement, more documentation is needed. Medical data needs to reflect overall care provided in order to gauge the effect of iv education on glycemic control and birth outcomes. To decrease barriers of reviewing a chart, the extraction of chart data should be accomplished solely by the principal investigator. Recommendations for future outcomes studies should include collecting data on a continuum of clearly defined blood glucose levels during pregnancy to reflect the effect diabetes and nutrition education has on glycemic control and birth outcomes.
    • A Doctoral Program in Leadership and Policy Studies: Is It Feasible?

      Killorin, Mary (Institute of Social and Economic Research, University of Alaska., 2002)
      In response to requests from the Alaskan community, the University of Alaska Fairbanks (UAF) agreed to explore the possibility of developing a doctoral program in leadership and policy studies. This program would be developed in collaboration with the University of Alaska Anchorage (UAA) and the University of Alaska Southeast (UAS). The goal of the program would be to prepare Alaska leaders in the fields of education, health and human services, government, and business. The report is organized around the six main questions that respondents answered. Each question has a summary of responses indicated by bulleted themes followed by supporting quotations.