Running head: HEALTH PLANNING PROJECT: DRUG COURT

Health Planning Project Health Planning Model: Drug Court

Abigail Hren, Blair Howell, LaTonya Warren, Andrea Ramirez, Nicholas Grose, Mark
Managuio, Alexis Miner, Courtney Carretero, Bezawit Fissaha
Old Dominion University

HEALTH PLANNING PROJECT: DRUG COURT

Health Planning Project: Drug Court

The purpose of this assignment is to utilize the Health Planning Model to improve
aggregate health and to apply the nursing process to the larger aggregate within a systems
framework. After working with the aggregate for eight months, the students utilized the nursing
process to provide education to improve the health outcomes of the Norfolk drug court members.
The scope of this paper includes stated health problems of the aggregate, measurable outcomes,
alternate and actual interventions, implementation barriers, outcome evaluations, and future
recommendations.
Planning
Nursing Diagnosis & Health Problem
The Norfolk Drug Court group (aggregate) as a whole has deficient knowledge
related to health literacy as evidenced by illicit drug use, elevated blood pressures, unhealthy
diets, lack of physical exercise, nonadherence to medication regimens, and smoking. There were
multiple health problems within the Norfolk Drug Court aggregate, however, our team identified
health literacy as it best generalized other underlying problems. Health literacy can be defined as
the degree to which an individual is able to obtain, comprehend, process, and understand basic
health information, which is essential in making appropriate health decisions (Ingram & Ivanov,
2013). Health literacy is a skill required to fully benefit from any health services provided. The
aggregate demonstrated many instances of inadequate health literacy, which include
nonadherence and misuse of the recommended medication regimen, poor results on surveys and
tests, and the inability to correlate the impact that diet and exercise have on their medical
condition. As a result, a significant amount of the aggregate suffered from chronic hypertension

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3
related to their decreased health literacy and overall awareness of related effects of this disease
process.
The majority of the aggregate consumed a diet high in fat, sodium, and sugar and did not
correlate the effects that this had on their overall health status. An example of the lack of health
literacy was made apparent when members of the aggregate would claim that they could lower
their blood pressure if they could just have a cigarette before having their blood pressure
measured. Medication adherence was affected by financial problems and inadequate knowledge
of side effects. We identified general health literacy comprehension as the ultimate goal for the
drug court aggregate. This would be achieved by providing focused educational sessions on
topics including the importance of adhering to the prescribed medication regimen, the impact
that diet has on health, proper ways to manage side effects, healthy ways to manage blood
pressure, diabetes, and education on basic medical terminology.
Measurable Outcomes
Focused education on these topics will significantly improve the general health of this
population thus improve the health literacy of the aggregate. By the end of these focused
educational segments, the client should be able to state the significance of adhering to the
recommended medication regimen and identify the effects of missing or increasing medication
dosages. The client should be able to identify strategies to manage side effects as well as
recognize complications. This can include identifying signs and symptoms related to
hypertension, hyperglycemia, and hypoglycemia. The aggregate should be able to identify
significant warning signs such as a headache, syncope, and dizziness (McNaughton, Jacobson, &
Kripalani, 2014). Norfolk drug court members should also be able to state lifestyle
modifications they can make to assist in decreasing their blood pressure and assisting with

HEALTH PLANNING PROJECT: DRUG COURT

4
keeping their blood sugar within normal limits. This includes losing weight, limiting the
consumption of caffeinated and high sugar beverages, significantly reducing their intake of
sodium to less than 1.5 grams per day and effectively reducing and managing stress (Semlitsch et
al., 2016).
For clients using antihypertensive medications, by the end of April they will demonstrate
an understanding that they may speak with their healthcare provider about modifying the times
that they take their medication in order to avoid nocturia. Nocturia is a common side effect of
some antihypertensive medications that is a nuisance and can cause sleep disturbances. It is also
essential that the aggregate understands the importance of reporting any significant side effects
to their primary care provider (McNaughton et al., 2014, p 352). Furthermore, the aggregate
should be able to identify positive changes that could be made in order to promote a healthy
lifestyle and progression through the recovery process. Healthy methods that should be
identified include exercising regularly, eating foods high in protein and low in fat, cessation of
smoking, and maintaining a healthy weight according to his or her ideal body mass index (BMI).
The drug court members should be able to identify the following as negative contributors to their
health: smoking to reduce blood pressure readings and eating foods high in fat, sodium, and
sugars. Many of the group members requested a follow-up blood pressure reading after smoking
a cigarette; they believed that smoking can temporarily reduce their hypertension. The aggregate
should be able to identify basic medical terminology along with being able to accurately interpret
a medicine prescription for the frequency of dosage and when a refill is needed by the end of the
30-minute lesson. The success of these objectives can improve the health literacy of the drug
court aggregate and have a lasting impact on their road to sobriety.

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5
Within the setting of the drug court, interventions that could be utilized to increase the
likelihood of completing the objectives would be to have a healthcare provider on staff. This
would ensure that the members of the drug court are regularly monitoring their blood pressures,
having health related questions pertaining to medications, nutrition, and coping skills adequately
answered, and progressing through the detoxification and sobriety process in a healthy manner.
In the community, it is important for members of the aggregate to have access to consistent and
reliable health care. Increasing the awareness of clinics and health care facilities in the area will
allow for aggregate members to monitor and follow up on health conditions that they are
currently encountering. If drug court members are aware of locations that they can be seen for
health conditions, other than the emergency room, it can result in favorable outcomes related to
increasing their health literacy. Members may be more likely to utilize the services, which will
increase their understanding of their medical conditions and medication regimens, thus
improving health and wellbeing.
Establishing a permanent staff healthcare staff member could prove to be a vital resource
for the aggregate and the staff. Many times if the aggregate has questions regarding medications
or health related issues, they are directed at the councilors who are not adequately trained to
answer the question appropriately. Drug court members could benefit from having a resource
available to them to help transition from the unhealthy lifestyle related to drugs and alcohol to
their future life of health and sobriety. Roberts, Wheeler, and Neiheisel (2014) stated that using
the time between nurses and patients is a way to assist them with medication adherence, build a
trusting relationship, and create protocols for assisting patients and preventing nonadherence.
The utilization of a healthcare provider on staff could improve the overall adherence medications

HEALTH PLANNING PROJECT: DRUG COURT

and lifestyle changes and aid with the members of drug court achieving their healthiest

functional level and aid in maintaining their sobriety.

Interventions
Implementation
The interventions provided to the aggregate include measures of primary, secondary,
and tertiary prevention. These interventions are applied in regards to the previously determined
nursing diagnosis of deficient knowledge related to poor health literacy with the primary health
problem being high blood pressure. Researchers in 2014 published in Medical Care examined
the association between health literacy and elevated blood pressure and found an extremely
elevated blood pressure was more common in those with a low health literacy (McNaughton,
Kripalani, Cawthon, Mion, Wallston, & Roumie, 2014). Without sufficient knowledge of health
literacy, it could lead to decreased awareness of signs and symptoms that indicate serious
complications, such as stroke, seizures, and other health problems that may result in death if not
detected early. Additionally, poor health literacy may result in unnecessary treatments for
conditions that can be resolved with non-pharmaceutical methods, such as relaxation, exercising,
change in nutrition, and other methods.
Primary prevention seeks to prevent the onset of disease by risk reduction through
planned education activities with the goal to promote health. Health promotion activities
included organized group educational sessions of lecture and interactive discussion format on the
topics of healthy diet and exercise, stress management, and improving general health literacy.
Providing health promotion activities brings awareness and enhances learning experience to
prevent serious complications from occurring. Health promotion activities also included
interactive learning with the use of the Jeopardy game format. Aljezawi and Albashtawy (2015)

HEALTH PLANNING PROJECT: DRUG COURT

7
conducted a study to compare adult students performance, satisfaction, and knowledge retention
between a Jeopardy style learning format and traditional didactic lecture format. Sixty-six
students were randomized into a control group who received the traditional lecture format and an
intervention group who received the Jeopardy game format. Each member of the sample was
given a pretest to assess baseline subject knowledge, a post-test which evaluated knowledge
following teaching, and a satisfaction survey following teaching. Results of the study showed
that the Jeopardy-style format of learning was well-liked, more satisfying, and promoted greater
information retention when compared to the traditional didactic lecture format.
Each month the aggregate receives health promotion activities related to promoting
methods for proper self-care, to prevent acquirement of sexually transmitted diseases (STDs) and
human immunodeficiency virus (HIV), and to encourage positive coping mechanisms.
Festinger, Dugosh, Kurth, and Metzger (2016) conducted a study to evaluate 200 adult felony
drug court participants, who were randomly assigned to computerized HIV prevention
interventions, to evaluate the efficacy for receiving brief sessions to reduce the risk for HIV. The
results show that participants who received brief, educational sessions for HIV prevention
interventions had an increase in reporting HIV testing, condom use, and reduced sexual risktaking. Health promotion activities serve as a beneficial and crucial method for preventing
future issues from occurring from befalling patients, especially the aggregate.
Secondary prevention includes procedures designed to detect disease processes early and
prevent disease progression. Secondary prevention for the aggregate included blood pressure
screenings, and informing individual aggregate members if their blood pressure readings were
abnormal. The rationale for providing blood pressure screenings to the aggregate is due to
clients having an interest in monitoring their blood pressures as well as providing a free

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8
convenient resource to individuals that may have never had their blood pressure checked. In
addition, recommendations were made to individual members to seek care from a primary
healthcare provider or to seek immediate medical attention if their blood pressure was within the
hypertensive crisis range of higher than 180 systolic, or 110 diastolic. Prendergast et al. (2015)
conducted a cross-sectional study of ED patients with asymptomatic high blood pressure and
heart disease, where they performed ultrasounds, such as echocardiograms, and annual blood
pressure measurements. While performing these procedures, the patients received education
pertaining to uncontrolled hypertension and complications related to high blood pressure. The
study showed that patients who received educational sessions had significant improvements in
blood pressure readings. Screening patients while reinforcing educational interventions
enhances patient's understanding and awareness of how to manage blood pressure and other
health conditions.
Tertiary prevention includes the education and treatment of diagnosed acute or chronic
illness and seeks to reduce the severity or impact of the disease. Tertiary prevention to the
aggregate that has already been diagnosed with a chronic illness such as hypertension or
diabetes. According to Low, Pelter, Deamer, and Burchette (2015), an individual in the age
group between 40-70 years old with high blood pressure have a double the risk for
cardiovascular disease and associated complications such as heart attack, heart failure, kidney
disease and stroke. Health promotion interventions included the reinforcement of knowledge on
the disease process so one can understand why their health is impacted by it, providing the
members with information that will help them access health care, as well as reinforcing
information regarding maintaining a healthy diet, exercising regularly, weight management.
Tertiary interventions also included providing the aggregate with tangible reading material that

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included topics such as hypertension management and resources for free or reduced-cost
healthcare services. The reading material provided was sensitive to the literacy level of the
aggregate. According to Ryan et al. (2014) use of materials that are written in a way that
facilitates the uptake and use of patient education content has great potential to improve the
ability of patients and families to be partners in care and to improve outcomes, especially for
individuals with limited health literacy or reading capabilities (Ryan et al., 2014, p 218).
A 2011 study published in the Journal of International Nursing Studies examined the
relationship between illness perceptions and adherence to treatment among patients with
hypertension. Using a cross-sectional, descriptive, correlational design, researchers collected
data from 355 hypertensive patients at three cardiovascular centers in Taiwan. Data was
collected using structured questionnaires to include the Illness Perception QuestionnaireRevised, Medication Adherence Inventory, and the Inventory of Adherence Self-Management
(Chen, Tsai, Chou, 2011). The findings of the study demonstrated that perception of the ability
to control the disease directly affected adherence to prescribed medications and selfmanagement, while perception of the cause of disease only impacted adherence to prescribed
medications which suggests that adherence to therapeutic regimens may be enhanced by
improving a sense of controllability (Chen, Tsai, Chou, 2011, p 235). Results of this study
support tertiary teaching interventions that were not only directed toward education regarding
disease process, but education regarding modifiable risk factors such as diet, exercise, and stress
management as well.
Barriers
The main barriers to the aggregate is a lack of access to healthcare and the financial
ability to pay for healthcare services and medications. The financial status of the aggregate also

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impacts the ability to make recommended lifestyle changes such as healthier food choices for
example. Other barriers include low health literacy, busy schedules, nonadherence, and
misinformation pertaining to health. These barriers were noted through observation of the
educational sessions and interaction with the aggregate. During lectures for nutrition teaching,
many of the members felt they had adequate knowledge of methods for healthy living, but
argued if what was being taught went against what they believed to be true. Many also seemed
uninterested in participating in the group game, until they realized there were prizes to be won.
Another barrier noted during teaching session occurred when the aggregate was given tests prior
to and after teaching, and they would occasionally ask the program coordinator or their peers
about several of the questions. While reviewing results, a majority of the aggregate either
replied that they did not know the answers, or left the answer section blank.
Low health literacy has a large impact on how the aggregate perceives the care that they
receive from healthcare professionals. Some of the common complaints from the aggregate
included the inability to understand the subject matter presented by physicians, not knowing
what questions to ask about their health, and/or when follow-up visits were needed. This issue
could lead to other complications, such as inadequate knowledge on how to maintain health and
manage medications. Karakurt and Kasikci (2012) conducted a study to evaluate medication
adherence of 750 patients with hypertension in Turkey, and factors that may affect adherence to
regimen by providing questionnaires as a data collecting method. According to the study, 45.5%
of the patients were illiterate, 66.1% lived under low income, and 57.9% did not take medication
due to forgetfulness, aloneness, or negligence. These findings can be related to issues of the
aggregate where a majority of them live in low-income housing, difficulty searching for jobs to

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support their needs, and low educational status, where they may not have the resources needed to
assist them to understand their medication regimen and methods to adhere to the regimen.
Evaluation
Plan
While working with the aggregate our group decided to create individual teaching
activities coupled with pre and post tests on the same day as the teaching activities to evaluate
the aggregate absorption of material followed by a cumulative post-test of all teachings at a later
date. We gave the aggregate approximately 2 weeks from the last teaching and then
administered a comprehensive 13 question test incorporating objectives from all the teachings, as
seen in appendix E. We then analyzed the results of these tests to determine if the aggregate had
retained any of the teachings that we provided. There was no review prior to administering the
cumulative test, and each member of the aggregate took it individually.
The teaching that we provided to this aggregate population was focused on promoting
healthy lifestyles. The teaching aimed to increase aggregate comprehension of medical
terminology, healthy dietary choices, healthy coping mechanisms associated with addiction
rehabilitation, blood pressure management, and medication compliance. It was expected that the
teaching provided to the aggregate would produce an immediate increase in understanding of the
topics. It was expected that the cumulative post-test would produce results indicating that a
majority of the aggregate retained the information taught to them.
Evaluation Process
We utilized different evaluation processes with each teaching to give us a better
understanding of the knowledge of the aggregate. One form of evaluation that we used was pre
and posttests. These were used so that we could gain an understanding of what the aggregate

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knew before the teaching occurred, and it helped to evaluate the effectiveness of the teaching that
we provided. Another form of evaluation that we used with this population was open discussion.
This allowed us to evaluate not only their understanding of our teaching but to also ascertain
different aggregate members reasoning of what they learned. We also used a game to evaluate
the aggregates learning. The game was modeled after a jeopardy-like format. This was used to
increase the aggregates interest in learning and it also provided us with a way to see the
effectiveness of our teaching.
Limitations
With each of the teachings and the cumulative post-test, there was one common
limitation of new drug court clients taking the test when they were not present for any of the
teaching lectures. In the case of the coping mechanisms lecture, new clients that started the
program did not understand what moral recognition therapy (MRT) was while the other clients
had been undergoing this therapy each week with the drug court counselors during group
session. This lead to confusion and misunderstanding during the lesson about how MRT can
help the client. Regarding the cumulative post-test, new clients would not have received the
teaching necessary to answer the posttest questions correctly, which limited our ability to
accurately determine total retained knowledge of material taught. We suggest that teaching be
implemented monthly rather than having multiple teaching projects all within a few weeks. This
would allow the newly admitted drug court members to learn and the older drug court members
to have previous teachings reinforced.
Other limitations faced were questions on the posttests that were above the reading
comprehension of the aggregate, and also the high turnover rate of the drug court members. The
inappropriate reading level lead to the aggregate not understanding questions, asking student

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nurses to clarify what the answers meant, or not answering questions. The high turnover rate of
drug court members leads to new members joining the program each week. This makes it
difficult to maintain teaching because the new members need to be caught up, or they skew the
results of our evaluations. All of these limitations lead to a larger limitation of the aggregate not
understanding that their pre and post-tests were an individual effort not meant for group
collaboration. In the future, rules should be more clearly stated and enforced to the aggregate if
pre and post-tests are administered. We also suggest that future pre and post evaluations are
tailored more toward the literacy level of the aggregate. In this case, it would be that of a
seventh-grade reading level or lower.
Recommendations
The cumulative post-test included an open-ended question for services the drug court
members would like to see provided by the Old Dominion University nursing students in the
future. There were many varied answers, but only two that had been mentioned before through
interacting and communicating with the members before the meetings. Some of the members
would like for the nursing students to regularly check blood glucose levels through a simple
finger stick. According to Fareed, Byrd-Sellers, Vayalapalli, Drexler, and Phillips (2013) clients
who use methadone have a higher intolerance to glucose than the general public. Furthermore,
the researchers stated that diabetes mellitus is more prevalent among individuals who have
abused opioids such as heroin or other intravenously injected drugs, as well the prevalence of
hepatitis C. Additionally, it is a known fact that diabetes is statically higher in African
Americans, Mexican American, and other minorities. Finally, the research states that a high
percentage of methadone maintenance treatment clients die prematurely due to uncontrolled
blood glucose. A few of the Norfolk drug court members are on methadone, the majority are

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African American, many are opioid abusers, and a few are hepatitis C positive. Therefore, in the
future, conducting a simple finger stick blood glucose level check could save more lives and help
encourage the drug court members to exercise more, be conscious of what they are consuming,
and better control stress in conjunction with the blood pressure monitoring.
Another service some of the members would like the Old Dominion University
student nurses to provide is easier access to condoms. Festinger et al. (2016) express that
approximately 1.5% of the prison population is HIV positive. Moreover, 17-25% of the United
States HIV positive individuals pass through the criminal justice system yearly. Festinger et al.
found that over half of drug court members sampled had high-risk sexual practices to include
having multiple sex partner and unprotected sexual encounters in the past six months. Through
the education provided by the nursing students at Old Dominion University, it was evident that
the members of the Norfolk drug court also have high-risk sexual practices. The members of the
Norfolk drug court expressed some anxiety when the lecture said to only have one sexual partner
at a time. The research by Festinger et al. also found that providing a 20-minute lesson on HIV
reduction that was applicable to the drug court member about every six months increased the
HIV testing and condom use rates. It is important to add that the researchers provided free
condoms at each education session. Therefore, it is our recommendation that a bowl of free
condoms is left in an accessible place in the drug court building every few months.
The nursing students have already set in motion a plan to begin free glucose
testing. The students communicated the need for this service to their instructor and are waiting
for approval for the service. Additionally, the students spoke with Access Aids of Norfolk on the
issue of leaving a bowl with free condoms for the drug court members since the organization

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visits the drug court once a month and has funding for large quantities of male and female
condoms.
Implications for Community Health Nursing
The Norfolk drug court faces various health related issues while they continue to recover
from their drug addictions. Community health nurses act as a support system for these clients to
successfully complete the program. Nurses need to be aware that this aggregate is a very
vulnerable population. The aggregate faces many internal and external stressors as they attempt
to make huge changes in their lives. Internal stressors include but are not limited to the inability
to meet goals they set for themselves, experiencing drug withdrawals, and temptations to relapse.
According to the National Institute on Drug Abuse (2014), stress, cues to the drug experience,
and exposure to drugs are the most common triggers for relapse. All of these triggers are very
easy to come across in daily life. Also, it was found that external stressors include attending
mandatory meetings, maintaining a job, paying program fees, and participating in weekly drug
testing. From our experience with the clients, there were times where they would complain
about the weekly drug testing. Some of them in the past have gotten caught with positive drug
tests and were given sanctions to be jailed. Other clients found it hard to find or maintain a
steady job, which is required of them to progress in the program. Clients can relapse, so it is the
responsibility of the community health nurse and drug counselors to be an available resource to
get them through it.
As mentioned earlier, health literacy is an issue that requires prioritization for these
clients. Effectively assessing the health literacy of the aggregate is beneficial, and reveals
underlying health problems that need to be addressed. Education from a community health nurse
is a valuable resource. Providing education can assist the aggregate to learn methods to promote

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health, attain compliance with medication regimens, reduce stress and stressors, and gain
knowledge of low-cost alternatives for daily life. Community health nurses providing primary
and secondary interventions will help prevent the need for tertiary interventions. Overall,
community health nurses need to be aware of the issues of the aggregate and provide
interventions as necessary.

HEALTH PLANNING PROJECT: DRUG COURT

References

17

Aljezawi, M., & Albashtawy, M. (2015). Quiz game teaching format versus didactic lectures.
British Journal of Nursing, 24(2), 86-92 6p. doi:10.12968/bjon.2015.24.2.86
Chen, S., Tsai, J., & Chou, K. (2011). Illness perceptions and adherence to therapeutic regimens
among patients with hypertension: a structural modeling approach. International Journal
of Nursing Studies, 48(2), 235-245 11p. doi: 10.1016/j/ijnurstu.2010.07.005
Fareed, A., Byrd-Sellers, J., Vayalapalli, S., Drexler, K., & Phillips, L. (2013). Predictors of
diabetes mellitus and abnormal blood glucose in patients receiving opioid maintenance
treatment. American Journal on Addictions, 22(4), 411-416 6p. doi:10.1111/j.15210391.2013.12043.x
Festinger, D. S., Dugosh, K. L., Kurth, A. E., and Metzger, D. S. (2016). Examining the efficacy
of a computer facilitated HIV prevention tool in drug court. Drug and Alcohol
Dependence, 162(1), 44-50. Doi: http://dx.doi.org/10.1016/j.drugalcdep.2016.02.026
Ingram, R. R., & Ivanov, L. L. (2013). Examining the association of health literacy and
health behaviors in African American older adults: does health literacy affect adherence
to antihypertensive regimens?. Journal of Gerontological Nursing J Gerontol Nurs,
39(3), 22-32. doi:10.3928/00989134-20130201-01
Karakurt, P., & Kaiki, M. (2012). Article: Factors affecting medication adherence in patients
with hypertension. Journal of Vascular Nursing, 30118-126.
doi:10.1016/j.jvn.2012.04.002
Low, K. J., Pelter, M. A., Deamer, R. L., & Burchette, R. J. (2015). Identification and evaluation
of risk factors in patients with continuously uncontrolled hypertension. Journal of
Clinical Hypertension, 17(4), 281-289 9p. doi:10.1111/jch.12478

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Mcnaughton, C. D., Jacobson, T. A., & Kripalani, S. (2014). Low literacy is associated

18

with uncontrolled blood pressure in primary care patients with hypertension and heart
disease. Patient Education and Counseling, 96(2), 165-170.
doi:10.1016/j.pec.2014.05.007
McNaughton, C.D., Kripalani, S., Cawthon, C., Mion, L.C., Wallston, K.A., & Roumie, C.L.
(2014). Association of health literacy with elevated blood pressure: a cohort study of
hospitalized patients. Medical Care, 52(4), 346-353 8p.
doi:10.1097/MLR.0000000000000101
National Institute on Drug Abuse. (2014, July). Treatment and Recovery. Retrieved April 18,
2016, from https://www.drugabuse.gov/publications/drugs-brains-behavior-science
-addiction/treatment-recovery
Prendergast, H. M., Colla, J., Del Rios, M., Marcucci, J., Schulz, R., and ONeal, T. (2015).
Playing a role in secondary prevention in the ED: longitudinal study of patients with
asymptomatic elevated blood pressures following a brief education intervention: a pilot
study. Public Health, 129(1), 604-606. Doi: http://dx.doi.org/10.1016/j.puhe.2015.02.001
Ryan, L., Logsdon, M. C., McGill, S., Stikes, R., Senior, B., Helinger, B., & Davis, D. W.
(2014). Evaluation of printed health education materials for use by low-education
families. Journal of Nursing Scholarship, 46(4), 218-228 11p. doi:10.1111/jnu.120
Roberts, M. E., Wheeler, K. J., & Neiheisel, M. B. (2014). Medication adherence part three:
strategies for improving adherence. Journal of the American Association of Nurse
Practitioners, 26(5), 281-287 7p. doi:10.1002/2327-6924.12113
Semlitsch, T., Jeitler, K., Berghold, A., Horvath, K., Posch, N., Poggenburg, S., & Siebenhofer,
A. (2016). Long-term effects of weight-reducing diets in people with hypertension.

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Cochrane Database of Systematic Reviews Reviews.
doi:10.1002/14651858.cd008274.pub3

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Appendix A

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Coping Mechanisms Teaching Pre-Test

1. What does MRT stand for?
a. Medical Related Treatment
b. Moral Reconation Therapy
c. Migraine Related Treatment
d. Moral Recognition Therapy
2. True or False: It is not uncommon for people who helped you through addiction to lose
themselves and have to find their self being again during your recovery.
3. What are unhealthy coping mechanisms? Select all that apply.
a. Exercise
b. Avoidance
c. Displacement
d. Procrastination
4. How does MRT work?
a. By forcing addicts to quit
b. By providing medications that assist with addiction
c. Encourages addicts to confront their issues
d. By punishing addicts when they relapse
5. What is rationalization?
a. Involves the use of logic or excuses to avoid facing the truth
b. Confronting the truth
c. Making bad decisions

HEALTH PLANNING PROJECT: DRUG COURT

d. Rationalizing good behavior

21

6. How do you cope with addiction? How do you think you can improve?
7. True or False: It is recommended to start a relationship in the first year of recovery.
8. The best thing to remember about recovery is:
a. Recovery for your friends and family works well
b. Recovery for yourself is fundamental
c. Recovery is based on finding a romantic relationship to help you through
d. Recovery is a simple process
9. What is one of the benefits of MRT?
a. Improves health physically and mentally
b. Leads to signs of addiction
c. Can lead to relapse
d. Completely eliminates addiction
10. What are healthy coping mechanisms? Select all that apply.
a. Exercise
b. Meditation
c. Denial
d. Journaling

HEALTH PLANNING PROJECT: DRUG COURT

Appendix B

22

Coping Mechanisms Post-Test

1. What does MRT stand for?
a. Medical Related Treatment
b. Moral Reconation Therapy
c. Migraine Related Treatment
d. Moral Recognition Therapy
2. True or False: It is not uncommon for people who helped you through addiction to lose
themselves and have to find their self being again during your recovery.
3. What are unhealthy coping mechanisms? Select all that apply.
a. Exercise
b. Avoidance
c. Displacement
d. Procrastination
4. How does MRT work?
a. By forcing addicts to quit
b. By providing medications that assist with addiction
c. Encourages addicts to confront their issues
d. By punishing addicts when they relapse
5. What is rationalization?
a. Involves the use of logic or excuses to avoid facing the truth
b. Confronting the truth
c. Making bad decisions

HEALTH PLANNING PROJECT: DRUG COURT

d. Rationalizing good behavior

23

6. How do you cope with addiction? What have you learned from this seminar?
7. True or False: It is recommended to start a relationship in the first year of recovery.
8. The best thing to remember about recovery is:
a. Recovery for your friends and family works well
b. Recovery for yourself is fundamental
c. Recovery is based on finding a romantic relationship to help you through
d. Recovery is a simple process
9. What is one of the benefits of MRT?
a. Improves health physically and mentally
b. Leads to signs of addiction
c. Can lead to relapse
d. Completely eliminates addiction
10. What are healthy coping mechanisms? Select all that apply.
a. Exercise
b. Meditation
c. Denial
d. Journaling

HEALTH PLANNING PROJECT: DRUG COURT

Table 1

24

Coping Mechanisms Data

Correct Answers Pre Test

Post Test

Correct

Incorrect

TRUE

Wrote
Some
correct
Answers

Correct

Incorrect

16

13

13

BCD

11

12

19

17

13

12

FALSE

19

15

14

11

16

14

ABD

13

11

11

Wrote
Some
Correct
Answers

Personal
Response

23 total pretests

18 total posttests

HEALTH PLANNING PROJECT: DRUG COURT

Appendix C

25

HEALTH PLANNING PROJECT: DRUG COURT

26

HEALTH PLANNING PROJECT: DRUG COURT

Appendix D

27

HEALTH PLANNING PROJECT: DRUG COURT

28

Table 2
Short Assessment of Health Literacy- English (SAHL-E) Questionnaire results
Date administered: Monday March 7, 2016
Number of completed questionnaires: 21
number of missed questions

% of survey respondents

33.3%

33.3%

14.3%

9.5%

4+

9.5%

HEALTH PLANNING PROJECT: DRUG COURT

Appendix E

29

Nursing 2016 Teaching Post test

1. The best thing to remember about the recovery process is:
a. Recovery is a simple process
b. Recovery is based on finding a romantic relationship to help you through the process
c. Recovery should be for yourself
d. Recovery for your friends and family works well
2. What are unhealthy coping mechanisms? Select all that apply.
a. Exercise
b. Avoidance
c. Displacement
d. Procrastination
3. What is one of the benefits of MRT?
a. Improves health physically and mentally
b. Leads to signs of addiction
c. Can lead to relapse
d. Completely eliminates addiction
4. When taking your medications you should:
a. take your medication exactly as prescribed by your physician, nurse practitioner, or
physician assistant
b. Borrow medication from friends or family when you run out
c. Stop taking your medication because you feel better
d. Split your medication in half to make the amount of pills last longer
5. If your doctor tells your blood pressure is 190/100, what does this mean?
a. Your systolic blood pressure is 190 and diastolic blood pressure is 100
b. Your systolic blood pressure is 100 and your diastolic blood pressure is 190
c. Your blood pressure is within the normal limits
d. Your total blood pressure is 290
6. Risk factors that can lead to hypertension include which of the following
a. Age
b. race/ethnicity
c. Gender
d. Family history
e. All of the above answers are correct

HEALTH PLANNING PROJECT: DRUG COURT

30

7. Your doctor tells you that you are at risk for diabetes and you have a high A1C level. What
does the A1C level mean?
a. A1C is the average blood sugar level over the past 2 or 3 months
b. A1C is a snapshot of what my blood sugar levels are right now
c. A1C levels range from 60 - 100
d. A1C levels are not important when diagnosing diabetes
8. You pick up your blood pressure medicine from the drug store and notice that there are 90
pills in the bottle. Your doctor told you that you need to take 3 pills per day. How many days
will the bottle of blood pressure medication last you?
a. 25 days
b. 45 days
c. 30 days
d. 90 days
9.What effect does sugar have on the heart?
a. Increases chance of heart attack
b. Increase chance of stroke
c. Lowers good cholesterol
d. All of the above?
10. What is the average daily recommended intake of sodium for a healthy American?
a. 2400mg
b. 1500mg
c. 2000mg
d. None of the above
11. What mineral can be added to your diet to help balance sodium and lower blood pressure?
a. Nothing
b. Potassium
c. Iron
d. All of the above
12. In the future what would you like the nursing students to focus teaching (smoking hazards,
sexual health, hypertension, etc)?
13. In the future what services (blood pressure etc) would you like the nursing students to
provide?

HEALTH PLANNING PROJECT: DRUG COURT

Table 3

31

2016 Post Teaching Results

Some
Correct
Question

Correct

Number

Answer

Answers
Correct

Incorrect

27 total

Given

1 C

22

2 BCD

12

3 A

17

10

4 A

27

5 A

20

6 E

19

Unanswered

tests given
2

13

15 (most
common
answer was
7 A

9 b)

8 C

24

9 D

16

10 A

21

11 B

16

Sexual
12

Health*,

Responses

smoking

*=top three

10

HEALTH PLANNING PROJECT: DRUG COURT

hazards*,
stress relief,
hypertension*,
healthy foods
and their
benefits
Trojan
condoms,
exercise,
blood
pressure, eye
exams, cancer No most
awareness, all popular
vitals, EKGs,

answer,

where to get

most stated

Hep C

just teach

assistance, flu what you

13

shots, sugar

think is

Responses

levels

important

32