SESSION D (3:20-5:00PM)
Location: Ballroom, A. Ray Olpin University Union

Improving Neonatal Resuscitation Curriculum Using Demographic Information and Preferred Learning Methods from Guatemalan Lay Midwives
Ella Baker, University of Utah

Faculty Mentor: Kimberly Garcia, University of Utah

SESSION D (3:20-5:00PM)
POSTER D49

Midwives throughout the world practice in vastly different geographic areas, socioeconomic contexts, and with a variety of resources. Though midwives attend the majority of births across the globe, their role and educational opportunities are not standardized. Training in crucial skills, such as neonatal resuscitation, is often inadequate or inaccessible to midwives with limited literacy in developing countries, such as Guatemala. While the Guatemalan government has offered midwifery training since 1955, the training has failed to change midwife knowledge because they are taught with written material in Spanish, even though many midwives have limited literacy and speak Mayan dialects. More information is needed about how midwives best learn. This project aims to explore learning styles of midwives in the context of neonatal resuscitation training with a larger goal of ultimately decreasing neonatal mortality. The project was conducted at Refuge International Health Clinic in San Raymundo, Guatemala, which is a suburban area located approximately 30 kilometers from Guatemala City and the project included 12 midwives with 1 to 46 years of midwifery practice experience. Participants reported a range of literacy from none to an ability to read and write, and education levels ranged from elementary school through university. By means of a select-all-that-apply question added to a general demographic survey, the preferred learning styles of the lay midwives were assessed. Response options to the question, “What methods best serve your learning?” included color drawings, black and white drawings, verbal instruction, demonstration, storytelling, written instruction, hands-on practice, verbally repeating what you learned to someone else, acting out what you learned, writing down what you learned, and/or watching a video. Participants could select all methods that applied. While no one learning style was preferred by all participants, color drawings and verbal instruction were among the top choices. Due to the lack of clear patterns in the data, assessing group learning styles independently and tailoring educational methods to the unique needs of participants may be preferable to a more generalized approach.

Qualitative Usability Evaluation of the Revised Color Me Healthy App: Perceptions of Parents
Brianna Oliveros, University of Utah

Faculty Mentor: Lauri Linder, University of Utah

SESSION D (3:20-5:00PM)
POSTER D50

Background: Healthcare teams seek to alleviate symptoms of children that occur as a result of their disease and treatment. To support a person-centric approach to care, a mobile-based app, Color Me Healthy, was developed for children record their symptoms. The purpose of the study is to identify parents’ perceptions of the revised Color Me Healthy app’s perceived usefulness and perceived ease of use. Methods: Fourteen parents (11 mothers; median age 38.5 years) of children with cancer 6-12 years of age evaluated the app. Usability evaluations included audio recorded interviews which were analyzed qualitatively guided by following the Technology Acceptance Model (TAM). The TAM indicates that the perceived usefulness and the ease of use of technology determine its subsequent adoption. Interviews were transcribed and transcripts were uploaded into Dedoose software for analysis. Transcripts were reviewed to identify statements in which parents related aspects of the app’s perceived usefulness or ease of use. Statements were further coded using specific constructs set forth in the TAM. Results: Preliminary analyses are complete for seven parents. Statements from all parents supported the relevance of the app either for themselves or their child and the ability of the app to demonstrate meaningful results, providing evidence of perceived usefulness. Statements from all parents also reflected self-efficacy in using the app, providing evidence of its ease of use. Parents’ statements provided support for the perceived enjoyment of the app (n=4 parents) and the playful nature of the app (n=4 parents). Conclusion: Preliminary analyses indicate that parents perceived the Color Me Healthy app as useful and easy to use for the child to report their symptoms and for the parent to interpret their responses. Next steps include evaluation of the revised app’s clinical utility to support symptom reporting and subsequent initiation of interventions to alleviate symptoms.

Qualitative Usability Evaluation of the Revised Color Me Healthy App: Perceptions of Children
Haley Utendorfer, University of Utah

Faculty Mentor: Lauri Linder, University of Utah

SESSION D (3:20-5:00PM)
POSTER D51

Introduction: Through qualitative analysis of patient and parent transcripts, I have, in conjunction with Dr. Lauri Linder, gauged user reactions to novel technology in the form of an app titled Color Me Healthy, which was designed by the University of Utah’s Therapeutic Games and Apps Lab (The GApp Lab) to report pediatric cancer treatment symptoms. Stemming from the idea that children may often feel fatigue from conversing with doctors, nurses, and other healthcare workers almost constantly concerning their symptoms, an app would give them an avenue in which to relay their feelings electronically and create a consolidated area in which these reports can be viewed.  Methods: The purpose of this project is to summarize constructs from the Technology Acceptance Model reflected in statements by children with cancer who evaluated the revised Color Me Healthy app. Participants were 14 children 6-12 years of age (median 8.5 years) who participated in guided usability interviews ranging from 10 to 29 minutes (median 18.5 minutes). Interviews were transcribed and uploaded to Dedoose software for qualitative coding. An a priori coding process was used based on constructs defined in the Technology Acceptance Model. Initial coding of interviews was completed independently by three individuals with each “blinded” to the others’ coding. The group then met together to review and discuss responses and reach consensus. For my presentation, I will be focusing on the child perspective of these interviews. Results:  Interim analyses of 7 interviews are complete.  Discussion: For this project, researchers have implemented qualitative coding protocol describing Technology Acceptance Model constructs to statements from 14 children with cancer and their parents from guided usability interviews with the goal of determining necessary revisions to the app. Then, we began analyzing uploaded data with Dedoose software via a priori coding process, which is based on constructs and definitions set forth in the Technology Acceptance Model (TAM) as proposed by Venkatesh & Balain 2008. Initial coding of three child and parent interviews were completed independently with each individual “blinded” to other coding. Then, we have calculated Cohen’s kappa to evaluate inter-rater reliability after each three child and three parent interviews with the goal of achieving kappa ≥ 0.75. For constructs with kappa < 0.75, we gathered and talked through our logic to reach a consensus. At this point in time, we are currently halfway through analysis of all transcripts. Thus far, qualitative statements point towards the conclusion that both parents and children enjoy the app and find it relevant to the treatment they are receiving. As we finalize analysis this fall, we will prepare to effectively communicate the implications of our findings in order to improve upon the Color Me Healthy app and prepare it for clinical application.

Exploring the Relationship Between Traveling and Permanent Staff Nurses
Garrett Parker, Utah Valley University
Lauren Pacheco, Utah Valley Uinversity

Faculty Mentor: Francine Jensen, Utah Valley University

SESSION D (3:20-5:00PM)
POSTER D52

Background and Significance. Travel nurses are registered nurses who work in a non-permanent or temporary nursing role. They are usually employed by an independent nursing staffing agency instead of one facility. They are usually assigned to one hospital for 13 weeks (Hansen & Tuttas, 2022b). Travel nursing was initiated in the 1980s to address inadequate staffing in healthcare facilities with nursing shortages (Yang & Mason, 2022). During the COVID-19 pandemic an unprecedented increase in demand for nurses occurred alongside a mass resignation of 534,000 healthcare workers in what has become known as “The Great Resignation”, resulting in an RN vacancy rate of 8% nationwide (Hansen & Tuttas, 2022b). Prior to the pandemic travel nurses comprised less than 2% of the nursing population, but in 2020 the number of travel nurses increased by 35% in an effort to address the mass nursing shortage from the pandemic (Yang & Mason, 2022). In 2018 staff nurses earned an estimated average salary of $1,400 per week, whereas travel nurses were paid between $5,000 to $10,000 per week during the pandemic as their average salary rose by 25%. This discrepancy in pay has led to reported animosity between permanent staff nurses and travel nurses (Hansen & Tuttas, 2022a; Gan, 2020). This animosity has also led to a decrease in overall morale among nurses and a decrease in well-being, particularly for travel nurses, with reports indicating that 70% of travel nurses are at risk for poor mental well-being (Raso & Fitzpatrick, 2022). This animosity may contribute to a higher turnover rate for nurses. Understanding the experiences of staff nurses who work and interact with travel nurses could help guide future research to identify interventions to improve team relations between travel nurses and permanent staff nurses. To explore these experiences, a survey with questions about perceptions of travel nurses from the perspective of permanent staff nurses was performed (n = 31). An analysis of these responses demonstrated that almost all staff nurses believe that travel nurses have contributed to some staff nurses leaving their job on their units. Staff nurses had mixed reactions to the overall impact of travel nurses with more than half believing the travel nurses had a mixed (both positive and negative) impact on their units. The negative impacts were generally perceived to be a lack of training and unit knowledge amongst travel nurses, and an excessive pay discrepancy between travel and staff nurses. The positive impacts were perceived to be the introduction of new knowledge and techniques onto the unit. Based on these results, we recommend that travel nurses receive more extensive training on their new units and increase permanent staff pay to improve unit and staff morale.