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By Ginger Hall Carnes
Doctoral student Lorraine Barton, M.S.N., B.S.N., RN, compiled a questionnaire to help clinical staff at a non-traditional high school identify social and behavioral issues that can be detrimental to students’ health.
While working on her Doctor of Nursing Practice in the Advanced Practice Leadership track, Barton is conducting her doctoral project at the Healy-Murphy Center, a 120-year-old school in San Antonio that enrolls about 160 students with approximately one-third who are pregnant or parenting.
“My part is to put together a questionnaire regarding the social and behavioral determinants of health,” she explained.
The questionnaire is administered to students in the school health clinic to determine what services they need. “For example, if they screen positive for homelessness, then we need to get them in contact with shelters. If they screen positive for food scarcity, then we need to hook them up with food banks,” she said. Students do not reside at the school so the changes can affect their entire family.
Barton’s project is part of a grant led by Kathryn A. Parke, D.N.P., APRN, CPNP, an assistant professor/clinical who coordinates the Pediatric Nurse Practitioner course track in the School of Nursing at UT Health San Antonio.
An Indiana native, Barton earned her B.S.N. at Valparaiso University in Valparaiso, Indiana. She served for 27 years in the U.S. Air Force and retired as a colonel.
Barton said she didn’t see homelessness while taking care of Air Force active duty personnel and their dependents.
“Everybody had a place to live as part of the military, but there was a lot of depression and anxiety, especially after the big wars, 9/11 and Afghanistan. After screening them, they were referred to mental health services,” she said.
“Some airmen and their families were barely above the poverty level and needed to use federal assistance programs to help with food. Health literacy was also a problem. We helped them read their medication labels and other health information.”
During her military career, she earned a master’s degree in human resource management from Chapman University in 1996 and then earned her M.S.N. as a Pediatric Nurse Practitioner from UT Health in 2003.
After leaving the military in July 2016, she decided to use her GI bill to earn a doctorate because she wanted to be the best nurse practitioner she could be. In addition, some states are pushing for doctorate-prepared nurse practitioners.
As part of her doctoral project, Barton interviewed school staff and clinic staff and did focus groups with the students to find out what issues were prevalent among the adolescents at Healy-Murphy. “Then I took that list and went into the research literature to find validated screening questions.”
The questionnaire is used to screen students for those issues that were prevalent in the interviews and focus groups —depression, anxiety, health literacy, housing, food scarcity, nutrition and exercise, and risky sexual behaviors.
Barton is going through the feasibility phase of her project and already has screened many adolescents who were then referred by the clinic providers to needed services. This was never done before because there was no previous screening program.
“We hope this will become a permanent part of the clinic and eventually uploaded into their electronic health record.” Barton said.
She works at Aguirre Pediatrics on the south side where she sees a lot of the same issues and is hopeful that the screening questions for social and behavioral determinants of health can be adapted and used in other health clinics.
Barton is married to a retired Air Force electronic warfare officer and navigator who is now a math tutor. They have two daughters—one in college and one in high school.
Working full time while going to school and raising a family leaves little free time, but Barton sees immense value in her doctoral studies and fellow students. “We don’t all live in San Antonio, so we have a mega weekend for each class every semester where we meet face-to-face. We do webinars once or twice a month, and everything else is online,” she said.
“The doctoral degree focuses on delving into the literature and then applying evidence-based care to our clinical settings in the form of a quality-improvement project.” She plans to graduate in May 2018, continue working in this area, and “perhaps teach to bring up the next generation of pediatric nurse practitioners,” she added.