Alex Campagne

May 12, 2026: Today was the first day of my internship. When I first arrived at the office, I was introduced to the staff and given a tour of the building. I had a conversation with Dr. Thomas about the internship and expectations that we both set for ourselves for the course of the summer. After this, we discussed some research areas that were of interest to both of us and how public health plays a role in these areas. We discussed proper and improper patient selection for lumbar and cervical spinal surgery and how this impacted the patients’ follow-up, recovery, opioid usage, and overall well-being. We also bounced ideas around the proper and improper usage of opioids within those dealing with chronic pain and pain management. To go deeper, we discussed the current opioid crisis and how this can potentially be impacting patients who may seriously need these medications. We also went over my typical hours and days of work, which will be Monday-Thursday 8-4. I am not here on Friday’s since the office is closed then. We went over what a typical day in the office looks like and what the practice provides to its patients on a day-to-day basis. To get a better glimpse at the care the practice provides, I followed Dr. Thomas into a few patient rooms to get a firsthand look at proper bedside manner and professional healthcare communication between a provider and patient. 

I took my lunch break and jumped back into the internship. I had a brief conversation with the office manager, Charlene, on the odds and ends of the practice and how it functions as a whole. After this, I started to conduct some research on one of the topics Dr. Thomas and I had bounced around, improper patient selection for lumbar and cervical spine surgery. My first few searches were about educating myself on the differences between the types of surgery and the overall guidelines and criteria for one to be eligible for such an elective surgery. Not shockingly, the criteria are usually set by insurance companies on what areas a patient needs to qualify for in order for them to cover the operation. While not the overall guidelines, most patients will usually have to go by what their insurance provider says as an operation like this is not cheap whatsoever. I found a particularly interesting study on PubMed detailing how a preoperative diagnosis of a mood disorder can negatively impact postoperative patient-reported outcomes, complications, and opioid consumption. The direct impact on public health is due to mood disorders expected to increase in the general United States population, and therefore increasing healthcare utilization and costs in a time with a nursing shortage and increasing healthcare costs. Nearing the end of the day, Dr. Thomas and I had a conversation about my research and where I think the next steps were coming from. I am excited to return tomorrow and see where this internship will take me. 

May 13, 2026

Coming into the office this morning, I felt more at ease and comfortable since I knew what to expect and recognized the faces in the office. This morning Dr. Thomas and I had a chat about the use of opioids and the opioid crisis currently happening in the United States. We discussed how it has dual consequences in both a medical office/hospital setting and the broader public health setting. I also took a quick ten minutes to get my daily blog for this internship set up and ready to go on the website I used for my e-portfolio for my capstone project. After this, I jumped right into conducting research on the opioid crisis, the prevalence and statistics surrounding chronic pain patients in the United States in recent years, and finding articles outlining correct opioid usage in chronic pain and the management of chronic pain following the opioid backlash. This research would be the backbone of my first project of my internship: a research paper and project surrounding opioid usage and prescribing habits following the opioid backlash, the way this has impacted patients and providers alike, the stigma from using these medications, and potential alternative treatment methods and solutions to combating the current opioid policies and practices. I also wanted to focus some of my research and project space on how improved education and provider training can help with the prescribing of opioids and management of prescription opioids for patients and providers alike. After reviewing and taking notes on four articles, it was time for a quick lunch break. 

After lunch, Dr. Thomas and I had a conversation about my research and he encouraged me to think deeper about the public health aspects and consequences of both the overprescribing of opioids and how many chronic pain patients do seriously need these medications. He also gave me a book recommendation, Empire of Pain by Patrick Radden Keefe. To give a brief summary, it details the history of the Sackler family and their involvement with researching oxycodone. This eventually led to their marketing strategies targeting politicians, doctors, and government officials into endorsing the pill. It was a success at first, until many users began to abuse the medication and resulted in a new version that could not be crushed. After we wrapped up our conversation, I turned back to the web and started using new search queries to find additional articles and information on how healthcare providers can better educate themselves within the field of opioids and how the government and policies have impacted such topics. I found and took notes on several articles, the same pattern and key themes were found in a majority of them. This includes that there is currently a lack of healthcare provider training to prescribe opioids in a safe manner and a steady rise in the prescription of opioids. Eventually, it was time to head home for the day.

Weekly Summary/Competencies:

Competencies:

1. 1.1.3 Identify existing and available resources, policies, programs, practices, and interventions.

• Researching current regulations and “selection” for lumbar and cervical spine surgery and how this impacts the recovery process and therefore the public health impact on mental health, healthcare spending, and overall well-being of the patient.
• Researching the opioid crisis and how some healthcare providers may be hesitant to prescribe these medications or treat patients who have previously/currently on these medications for fear of liability or not knowing how to properly or safely navigate these potential addictions.

2.  5.2.6 Identify organizational policies and procedures and federal, state, and local laws that pertain to advocacy efforts.

• Researching and identifying current policies and practices within prescribing opioids and how this impacts the ability of patients who need these medications (cancer patients, emergency meds for those who may have a flare up of their condition, or end of life care)

3.  7.1.3 Involve partners and stakeholders throughout the health education and promotion process.

• Having routine conversations with Dr. Thomas about how to incorporate his work within the office and patients with my research to connect it to a broader public health and health promotion scope. I did this by taking some of his ideas and professional experience and researching how improper selection for spinal surgery can lead to adverse outcomes and that mental health also plays a role in this.

4. 1.2.3 Conduct a literature review.

• Beginning the first stages of research on opioid usage and prescribing habits following the opioid backlash, the way this has impacted patients and providers alike, the stigma from using these medications, and potential alternative treatment methods and solutions to combating the current opioid policies and practices.

5. 4.1.1 Align the evaluation plan with the intervention goals and objectives

• Ensuring that my research and activities pertain to the topics and direction of the office, since it is a pain management clinic. This also deals with making sure that my research can be beneficial to all patients, staff, and my work as a health promotion intern.

May 18, 2026: Coming into the office for week 2 of this internship, I was more prepared for what to expect and what was expected of me both academically and professionally. I started my morning as usual by having a conversation with Dr. Thomas about what would be on the agenda for this week and what was happening within the office. We discussed the project and research I had began last week which is about opioid usage, prescriber backlash, and the idea of de-prescribing following the opioid crisis. I jumped right back into my research surrounding this topic but expanded it to find articles about de-prescribing and both patient and provider attitudes surrounding this topic. Additionally, the data I find from this research can also be used in an additional project of creating health education materials for the office in safe opioid usage and how to safely and effectively stop taking medications when both patient and provider deem it safe to do so. I found one article on this topic and looked in the footnotes/citation section to find an additional article about patient attitudes and testimonial on de-prescribing of opioids and benzodiazepines. I took notes on the articles and additional notes on the public health/health promotion impact of such. These included the growing crisis of inadequate treatment of pain and the shame and stigma some patients may receive, and how public health campaigns should aim to raise and improve health literacy around the identification of high-risk medications and how to safely take these medications. Around this time is when I took my short lunch break.

After lunch was over, I wanted to take a slight break from my research and note taking and move onto creating some type of survey/questionnaire for office patients asking about what methods of communication they like best, their current knowledge on opioids, and alternative pain management techniques they know about or would like to learn more about. The data from this questionnaire could lead me to creating health promotion and educational materials for the office that are catered toward the office’s patients and directly address their needs, wants, and concern. This allows for the material to be personalized for the patients and shows that we as the office want to answer all their questions and concerns and give them factual advice and statistics on the topics they care about the most and that directly affect them. I wanted to use both closed and open ended questions to get the most specific answers possible while also making it easy to dissect and see what the patients appreciate most and what areas needed to be focused on. After creating the survey, I shared it with Dr. Thomas for input and feedback and he said it was a great starting point and he would think about anything else that I could add or think about what patients in the past liked or had the most questions on. After this, I continued my research on methods of de-prescribing, various alternative pain management techniques, and health literacy within the opioid sector. Eventually, it was time to head home for the day.

May 19, 2026: I started this morning off like all my other mornings by having a conversation with Dr. Thomas about my daily activities and if I had any questions or concerns about my responsibilities. I mentioned the questionnaire/survey that I had created yesterday for patient use and I wanted to see if he had any additional input. Dr. Thomas had mentioned that I should add demographic questions, which I had completely forgotten to add. He also encouraged me to find some research studies where the authors had a similar end-goal to see if my questions were worded properly and if I was missing any details or topics. From this, I discovered that my questions may have been too wordy and I needed to refine them so that way they were more straightforward and to the point. I did not want to overwhelm participants with a complicated questionnaire nor did I want them to become frustrated while completing such. Instead of going through the questions and rewording them, I basically started from scratch and rethought all of the questions. I wanted to go into it with a clean mind and start from the very beginning again. One thing that I have learned in this internship and even my academic career is that it is completely acceptable to sometimes have to ‘trash’ an existing draft, even if lots of time was spent on it, to start over to have a more clean and refined version. I would rather put my best foot forward over something that is not 100% that took lots of time. After all these adjustments, the questionnaire was now completed but I would wait to distribute to patients as I want my current main focus to be my research project that I began last week on opioid usage, prescriber backlash, the idea of de-prescribing following the opioid crisis, and how some patients who truly need these medications may now be left in the dark. It was now time to take a quick lunch break.

After lunch, it was time to dive back into my ongoing research project and find some additional articles and sources to eventually add to my literature review. One of the more interesting sources that I found and took notes on was conducted via interviewing patients who were current or former opioid users for pain management on their thoughts and viewpoints on medication cessation, focusing on both positive and negative viewpoints surrounding the topic. The researchers aimed to identify both barriers and enablers to cessation and they discovered that many of the emerging key themes were both barriers and enablers simultaneously. Another article that I discovered in my search was about older adults in the United States and their knowledge on opioids, any facilitators or barriers to de-prescribing, and their beliefs towards alternative, sometimes non-pharmacological, methods for pain management. What I enjoyed and appreciated most about this article is how it included patient/participant testimonials and they then connected these to the major key themes. The main results of this article included a fear of pain if they were to discontinue taking opioids for pain management and the need for an alternative medication if their opioids were to be de-prescribed. Another idea from the article was how patients were hesitant to switch medications since their current one was working and they were not falling into an addiction. Furthermore, a majority of study participants noted that alternative treatments would only work if it was the patient’s idea to try them out.

May 20, 2026: Today, I began my day my having a conversation with Dr. Thomas about my current research project and gave him updates on my new research findings and where I wanted to go from here. I told him I wanted to see if I could find 2-3 more sources and then move on to creating an outline. Creating the outline would allow me to see any key and emerging themes and see if I have any gaps that I need to fill in. I also mentioned how after creating the outline I wanted to take a step back and potentially begin working on patient education materials for safe opioid use, alternative pain management methods, and managing chronic pain during one’e daily life. He agreed with my points and I was sent on to begin my day. I started by looking over my current research notes to see if there were any areas I wanted to expand upon. After this, I found an article that interviewed 49 previous opioid users for chronic pain to get their experience and opinions on the cessation of opioid prescriptions. I found and additional article that is similar to the first about patients’ perspectives in tapering opioids and the corresponding risks, barriers, facilitators, and benefits. I read and took notes on these two articles to add to my previous notes and research. At this time, I took a quick lunch break.

Now it was time to transition to making some type of outline and grouping together my research notes into categories to try and identify emerging themes. This took me quite a while since I had a little over 15 pages of notes that were only organized my what source they came from and nothing else. I quickly realized that before I could start drafting an outline I would need to find some type of method to organize my notes or highlight the key findings and what stood out to me about each of the articles. Since all of my notes were typed on my computer, I went through and bolded all the bullet points/key findings that stood out to me and that I believed could be an emerging theme between all of the articles. When it came to any notes that I took on statistics or prevalences, I put these bullet points in italics as well. This did take me quite a while since I had around 10 sources and 15 pages to read and go through. After this step was completed, I went and separated the bolded and italicized points from the rest of the notes so I could look through and find emerging themes or similar patterns that displayed in more than one article. After doing such, it was time to head home for the day.

May 21, 2026: At the start of today, before having a conversation with Dr. Thomas, I looked over my notes from the day before to see if there were any themes or findings that stood out to me that I wanted to bring to his attention. Since I was still in the very early stages, there was nothing concrete that I wanted to report yet, but I did bring some statistics that I did not expect to his attention. One study with a sample size of around 50 participants who were all former opioid users had around 50% report that their pain had worsened after cessation of opioids, and the other 50% reported that their pain was the same or had even improved after their cessation of opioids. Dr. Thomas was impressed with the number of articles I had read and taken notes on and encouraged me to move forward in my “outlining” process, which would be today’s task. I had now moved on to sifting through all my notes and grouping any similar/emerging themes together to see what my main topics and themes would be. I first started by going through and separating general information and knowledge that could be used in an introduction paragraph, this was information such as pain awareness month and statistics about the overall usage of opioids within the United States and the number of people in the United States who live with chronic pain. I then went through and separated statistics that could be used in both and introduction and results section of a literature review. After this is when I went article-by-article and wrote a few sentences on the key findings and overall results of the articles to see if any key themes had emerged. Before I identified any themes, I took a quick break for lunch.

Some key themes that I discovered through my ten articles were provider and patient education on opioids usage, physicians were scared to face backlash or were now hesitant to prescribe opioids to patients, patients feared their pain would return and their, and quality of life would be impacted if they were forced to have cessation of opioids. As always, I also found multiple sub themes that could fit in a variety of main or key themes. These included barriers and enablers to opioid cessation, why should patients who are properly taking their opioid medications be forced to wean off opioids, the emergence of marijuana as an alternative to opioids, and patients hesitancy to trying and implementing alternative, sometimes non-pharmacological, methods of pain management. Dr. Thomas had a few minutes to speak so I went over the above with him and he was happy with the results but again wanted me to go back through and see if I could connect any points back to a broader public health/health promotion standpoint. I went through my notes again and created a new key theme about public health, society’s impact, and how individuals’ choices had impacted a whole society of those living with chronic pain. It was now time to head home for the day.

Weekly Competencies:

1. 1.2.3 Conduct a literature review.
   • Researching the opioid crisis, the methods of de-prescribing and how both patients and providers feel about such, former opioids users opinions on the cessation of opioids, patient testimonials on de-prescribing and cessation, and both barriers and enablers on the patient side to the cessation of opioids, and the beginning phases of organizing my research and creating an outline/identifying any gaps.
2. 1.3.4 Assess existing and available resources, policies, programs, practices, and interventions.
   • Researching and learning more about provider backlash when it comes to prescribing opioids following the opioid crisis.
3. 1.1.3 Identify existing and available, resources, policies, programs, practices, and interventions.
   • Conducting research on the barriers and enablers that patients see and face when it comes to the cessation of opioids and researching safe and effective use of opioids in former opioid users.
4. 6.4.2 Select communication channels and current emerging technologies that are most appropriate.
   • Creating a health survey/questionnaire for patients to evaluate and see what communication methods they prefer most, how they prefer to see health education materials, and assessing their current knowledge on opioids and alternative pain management techniques.
5. 7.1.3 Involve partners and stakeholders throughout the health education and promotion practice.
   • Regularly communicating and having conversations with Dr. Thomas about my work and receiving and implementing his professional and experienced input.
6. 4.1.1 Align the evaluation plan with the intervention goals and objectives.
   • Ensuring the all research, work, and time spent in office is health promotion and public health oriented and aligns with what the office practices, which is pain management.

May 25, 2026: Office closed for Memorial Day

May 26, 2026: I was not at the office yesterday since it was closed due to it being Memorial Day. My goal for this week was to get all my notes finalized and colored coded and placed into the correct categories whether they be for the introduction, results section, or basic statistics to be used throughout. I also wanted to get either a strong outline/beginning for the introduction done or fully write the introduction. After the introduction was complete was when I would then begin to write a solid outline for the paper. I told Dr. Thomas my plan and he agreed and told me to periodically check in with him but otherwise I was good to go. I tried a new system of organizing where I changed the font colors. For example, anything I had changed to red text would be for the introduction, anything italicized was key statistics, anything in purple highlight had a public health concentration, and anything in yellow highlight could be a potential solution or educational aspect to the issue at hand (opioid usage and misusage). All other key themes were in different colors, orange was managing those who needed opioids and those who had been on opioids for an extended period of time, green was about patient stigma, shame, and fear, purple was all about physician’s and their hesitancy to prescribe opioids following the crisis, and etc. After this, I took a quick break for lunch. 

Following my lunch break, I began to take all the information in red text and begin to formulate an introductory paragraph. I wanted to include information about how many patients in the United States live with chronic pain on a daily basis and explain the background for the paper, which was the opioid crisis and the consequences that came along with it for providers and patients alike. I also had found statistics and information on what the new no opioid policies were founded on and also included that. Additionally, I also added some public health points and consequences. I also added a point about how healthcare utilization for chronic pain is much higher for older adults than younger adults, as this would come into play later. My main goal for the introduction was to hook the reader in and want them to want to learn more about opioids and how the crisis has negatively impacted thousands of patients who had never previously misused these medications and how some providers were now scared to treat patients who had a history with opioids. After all of this, I had the beginning of a solid foundation for an introduction but knew I needed something more. I went back to the drawing board and did some more research to add into the introduction and even found some material for other areas of the paper. After all of this, it was time to head home for the day.

May 27, 2026: Coming into the office today began like all other days by having a conversation with Dr. Thomas about my end of day work yesterday and what my focus today would be on. I showed him my starting introduction and told him that my plan for today was to begin to outline all my key/emerging themes, public health impacts, and potential solutions which involve alternative pain management techniques. He liked my plan and told me to check in with him if I had any questions or concerns. After this, I went right to work taking all my notes and formulating them into outlines. All of my previous color-coding really helped me with this process and allowed my brain to see all of the key themes separately. Even though all my notes were colored coded, this step in the process did take me quite some time and by the time it was lunch I was able to get all my key themes into their respective categories on the outline.

After lunch, I began the outlines for the public health impacts and the potential solutions. I started to think about what step I should take next, I could either begin brainstorming for my discussion section or go back through and finalize my introduction paragraph and relook over my outlines for the results and potential solutions sections. But then this is when I remembered that every literature review needs a methods section, and this would be a good brain break in between all my organizing and outlining. I quickly wrote my methods section since I knew my inclusion and exclusion criteria and how I went about selecting my articles for the literature review. After all this, I was heading home for the day.

May 28, 2026: I began my morning like always and had a quick chat with Dr. Thomas about where I was currently with my literature review and my current progress. He liked where I was at and thought my outlines were at a good place to finally begin writing the results section of the paper, which would be my main task today. I immediately got started and decided to begin with the overall public health impacts, even though I wanted this paragraph to be last within the results section. Some of the main takeaways of this paragraph were that moving forward treating chronic pain needed to be evidence based and responsive to the needs of all patients. It also discussed how policies with opioids need not frame all patients as drug seekers and label physicians as reckless prescribers. The public health section also summarized the new growing crisis of not treating pain properly and those who need opioids for end-of-life care or end stage cancer should not suffer or be the unintended victims of others’ opioid abuse. After this paragraph, I moved into the potential solutions paragraph and outlined how alternative solutions need to be at agreement of both the patient and provider and not forced onto the patient. I also added testimonials from research articles that I read and took notes on. After all this, I took a quick lunch break.

Now it was time to construct my body paragraphs for my key and emerging themes from all of my research and note taking. This information would come directly from my outlines and should not take me long to construct. Ultimately, it was hard to narrow down the themes and decide appropriate names/titles for them. I ultimately went with (1) patient stigma, shame, and barriers, (2) fear from physicians to prescribe opioids, (3) patient knowledge and education surrounding opioids, and (4) patient experiences before and after opioid usage. I knew I would not be able to effectively write all four themes in one afternoon, so today I focused on 1 and 2. After this, it was time to head home for the day.

Weekly Competencies:

1. 1.2.3 Conduct a literature review
   • Still in the early stages, but have conducted research and taken notes on over ten peer-reviewed articles and began to organize the notes by category and color-coded them based on where they will be used within the literature review and if they belong in the introduction, if they are basic statistics, a direct public health impact, or are a key and emerging theme.
2. 1.2.4 Procure secondary data
   • Conducting research using peer-reviewed articles that have been published within the past 10 years and are based within the United States. All articles came from either medical or public health journals and are centered around the research topic at hand which is opioids, the opioid crisis, and patient and provider attitudes about de-prescribing and cessation of such medications.
3. 4.2.1 Determine purpose, hypotheses, and questions
   • Outlined within the introduction paragraph of the literature review, want to educate the audience and readers on the consequences of the opioid crisis and how it has affected both patients and providers alike in positive and negative manners.
4. 5.1.2 Examine evidence-informed findings related to identified health issues and desired changes
   • Using the notes from my research to identify key and emerging themes, specifically the articles that discuss patient attitudes to cessation and de-prescribing practices and both enablers and barriers to these processes, respectively.
5. 7.1.3 Involve partners and stakeholders throughout the health education and promotion practice
   • Regularly communicating and having conversations with Dr. Thomas about my work and receiving and implementing his professional and experienced input.

June 1, 2026: Today I began my day by finishing up key themes 3 and 4 in my literature review. I already had all the information and statistics in my outline, I just needed to construct it into paragraphs and ensure my writing had a good flow and transitions within. My goal was to get 3 and 4 done before lunch and then go back over the entire results section to ensure smooth flow and transitions and check over for any grammar errors or if any areas were too wordy or did not make sense. I ended up being able to meet my goal and was able to finish and finalize these areas before lunch.

I did not have my morning conversation with Dr. Thomas today so we waited until after lunch. I updated him on my progress with the literature review and told him that I had officially completed the introduction, methods, and results section but ensured that after the paper was completed I would be going through and making edits and checking for grammar errors. He appreciated that the editing process is not done since he reminded me that there is almost always something to fix, this is also something that I learned in my various professional writing courses at UGA. It was now time to begin my discussion section, which is personally the hardest section for me to write and construct. In my previous literature reviews, I have always struggled with what information to include and what to not include. I wanted to ensure that I added enough information but not include unnecessary details. Sometimes, I would add information to the discussion that in all reality belonged in the conclusion. Due to this, I decided to find some videos on the internet and do some research and what makes a strong discussion section and what research I should be looking for to include. I found an article from San Jose State University that outlined it in an understandable manner for me. It said to summarize the key findings, put those into context, highlight any limitations, mention any unexpected results, highlight follow up research if possible, and try to find articles/research that may highlight any positives about potential solutions outlined in the paper. After this, I decided to create an outline of my discussion section beginning with my limitations, summarizing the key themes, and mentioning any results that were surprising or unexpected. Then I moved onto finding some articles that highlighted recent follow up research or facts on opioids usage. After all this, it was time to head home for the day.

June 2, 2026: I began my morning like all other mornings and had a conversation with Dr. Thomas about where I stood with my literature review and asked if he needed me to do anything or if he had anything he believed I should add. He told me to continue with my plan as I had been moving at a good pace and to update him accordingly and to go to him with any questions. I did not want to begin my day with writing my discussion, so I decided to go back and look at my old discussion sections from my previous literature reviews and compare it to my outline for this review. I thought that this could help me tremendously since like I said yesterday, this was always a hard section for me to construct. Doing this showed me what I should keep in my outline, what I should remove, and if there is anything else that I needed to add. After looking over my previous discussions, I realized this section needed to be divided up into subsections. These would be (1) summary of key themes, (2) limitations, (3) implications and future research. The section that would be the most writing and research heavy would be implications and future research, so this was the area I needed to refine in my outline. The goal was to find one article to match up with each of the key themes that could outline potential solutions or methods to help these issues. After finding articles to match up with my themes, it was time to take a quick lunch break.

After lunch, I jumped into writing my discussion section directly from the outline I created earlier in the day. Since I already had all the information and I just had to turn it into paragraph format this did not take me too long. After the discussion section was complete, I moved onto the conclusion. I made a brief outline before I began writing but I also looked over my conclusions from my previous literature reviews to see how I should base this one. I did not want to make it too long but also needed to include all the necessary information. I kept it short and sweet highlight the four key themes, the need for future research, and emphasized the need for public health interventions and campaigns for safe and effective opioid usage while not forgetting about those who truly need these medications. Finally, I had to put all of my sources into APA format and go through and add in-text citations throughout the paper. After all this, I headed home for the day.

June 3, 2026: My morning conversation with Dr. Thomas consisted of me telling him that I had finished writing my literature review but I was still going to go through it this morning and make edits and revisions. He had me email him a copy so he could look it over and make his own comments and revisions for me to apply. He said he would get it back to me by this afternoon. Now, I had the choice of what project I wanted to begin next. I knew that I wanted a break from writing and heavy researching so it was time to brain-storm. I had the ideas of creating pamphlets that could highlight safe opioid usage, pain management techniques that were mainly non-pharmacological, life style changes and self-management of pain, and understanding chronic pain. Ultimately, I could make pamphlets and educational materials for all of these subjects but I needed to pick one to begin with. I decided to start with pain management techniques that were non-pharmacological and even add in some over-the-counter remedies as well. I began to research these areas and I complied some articles that could be useful in this realm. I also researched some over-the-counter remedies and medications that could be useful to add. After I had collected all my articles it was time to take a lunch break.

After lunch, Dr. Thomas gave me a printed out version of my literature review with a few tweaks and revisions to add. I quickly completed these; however, this literature review still felt unfinished. For the time being, I was going to table it and continue on with my educational pamphlets. Now it was time to take the articles I found earlier and take some notes on information I could include in the pamphlets. I also took notes on the over the counter remedies, what they are best used for, the average price, where to find them, and how to safely and best use them for pain treatment. After all this, I organized the information into an outline of sorts on how I was going to place it into the pamphlet. The hardest part about this was what order I wanted to place the information. I had to decide essentially the most important information for this pamphlet as it would go near the front/beginning. Ultimately, some patients would pick it up, glance it over, and set it to the side not reading the entirety of it. Since I thought of this, I had to decide the order of information from essentially the ‘most’ important to the ‘least’ important. After the rough outline was created, it was time to head home for the day.

June 4, 2026: I started this morning by meeting with Dr. Thomas to go over my rough outline for my educational pamphlet on pain management techniques. He liked this idea and said that this was a good start. He reminded me that when I made the actual pamphlet to use plain and simple language and not to overwhelm the pamphlet with bright colors, he advised me to keep it neutral but not totally plain. I took his advice and would incorporate this later. My next step was to find what online program I wanted to use to create the pamphlet. The obvious choice for me was Canva. Next, I needed to find the correct template for the job. It would be a trifold brochure with six different ‘sides’ to add information onto, with one of the pages/sides being the title page. to draw the patients in. To start, I selected a template that was white and green and was not overly exciting or too colorful, but still had body and depth. I started by placing all the information on the template before organizing it creatively/stylistically and adding elements/decals. After this, I took a quick break for lunch.

After lunch, Dr. Thomas allowed me the opportunity to go into patient rooms with him for his office visits to see the day-to-day operations of the practice. We had been talking about this since I began but this was the first day where we put it into place. During this time, I was able to observe him in a clinical manner and see how he interacts with patients, observe proper bedside manner, and hear what needs the patients have. From this, it allowed me to jot down ideas and brainstorm for future projects I can complete during my internship and see what education materials are needed within the office. I did this for the entirety of the afternoon and headed home after.

Weekly Summaries: This week I mainly focused on finishing up my literature review and began to create one of my first educational pamphlets for patients within the office. One main lesson that I took away this week was that even when you finish a project and type the last word or add the final period, it is truly never done. There is always something to change, add, or edit. We are constantly thinking of news ideas and publishing new research articles. This was the case with my literature review, I completed my final edits and revisions but something still does not feel right. I am going to sit on it for a few weeks and then come back to it after some time. When it comes to my educational pamphlets, I am trying to put myself in the shoes of someone who would be viewing and reading the material. It can be easy to just add information and include an excess of words. My thought process is to make it as simplistic as possible while also drawing the patients in and giving them valuable and crucial information.

1. 1.2.3 Conduct a literature review
   • Finally piece together outlines, write all the sections, and go back through and make grammar edits and usual writing revisions. I also had Dr. Thomas look it over so I could apply any of his edits and recommendations.
2. 1.4.2 Prioritize health education and promotion needs
   • Ensuring that all materials created and research conducted is at the benefit of the patients within the office and is educational in nature and will help them in the areas of pain management and alternative methods to treating and living with chronic pain.
3. 4.2.1 Determine purpose, hypotheses, and questions
   • Outlined within the introduction paragraph of the literature review, want to educate the audience and readers on the consequences of the opioid crisis and how it has affected both patients and providers alike in positive and negative manners.
4. 5.2.5 Identify available resources and gaps
   • Seeing what materials are currently available to patients and creating new materials on underserved areas.
5. 5.3.1 Use media to conduct advocacy
   • Creation of health education materials for the office within the areas of pain management.
6. 7.1.3 Involve partners and stakeholders throughout the health education and promotion practice
   • Regularly communicating and having conversations with Dr. Thomas about my work and receiving and implementing his professional and experienced input.

June 8, 2026: I took a half day today since I had a funereal to attend in the morning so my day did not start until after lunch. Due to this, I wanted to maximize my time as best as possible. I decided to continue working on my health education brochure on pain management techniques that I had began last Wednesday. Since I was short on time today, I simply wanted finalize a first draft of the pamphlet. I had already added all the information on the sides/pages last Thursday but it was now time to organize it, make sure all the fonts and text sizes were concise, the colors all matched, add icons, check for grammar, ensure the information was in the correct order and there was a good flow between pages, and add references. I was able to complete this task in the afternoon and shortly after I was heading home for the day.

June 9, 2026: Today, I started my day like all others by having a conversation with Dr. Thomas about my current projects and if he had anything he wanted me to catch up on, begin working on, or a new topic to research. He did not have anything in particular but he liked my idea of creating health education materials and told me to continue down this avenue, but emphasized that I should always try and connect my work to public health. I already had some ideas brainstormed from last week so I pulled my next topic from there: understanding chronic pain. I felt that this was a need in the office since many patients only know pain as the aches and soreness they live with on a daily basis, and not the root or the science behind it. I spent the morning researching and finding articles to best describe chronic pain and the types and even used search terms to help explain it in simple terms, since this project is also a learning activity for me. By the time I was done, it was time for a quick lunch break.

After lunch, I was not quite ready to create another Canva brochure so I decided to do more research on another topic for a separate brochure about self management of pain. I was not exactly sure what this entailed so I did some broad research before beginning my note taking and I even asked Dr. Thomas if he had any ideas on search queries or areas to start. my search. He suggested researching daily habits to incorporate into your life and researching habits that we should eliminate to help with living with chronic pain (drinking, smoking, etc.). This was great guidance and led me in the right direction to begin my research and note taking. I compiled information some several articles about daily exercise, increasing movement, limiting sedentary behaviors, and leading life with a healthy diet. After all this, I was heading home for the day.

June 10, 2026: On this morning, I spent some time updating my internship reflection logs on this page and ensuring my weekly summaries and competencies were up to speed. This took quite some time but after I jumped right back in to my traditional daily work.

After lunch, I asked Dr. Thomas if I could go into patient rooms with him again as I wanted to see the patients’ current understanding and knowledge on chronic pain and the various types. This allowed me to see exactly what the patients within the practice needed and what areas I did not need to focus on. Like I have said before, these educational materials are a learning area for me but they ultimately are to educate and provide information to a group that I am not apart of. The goal is to gear my work towards them to best educate and give them knowledge on the pain they live with. My job as an intern is to help those around me and within the office, so I need to ensure that all my materials are created with this target audience in mind. Dr. Thomas and I also had a conversation about this and he agreed with my statements but also encouraged me to research this topic to educate myself before I try and educate others. After all this, it was time to head home for the day.

June 11, 2026:

Weekly Competencies: This week was all about ensuring that my work was patient centered and geared towards them. Even though I was learning new information during the process, I would have to put myself in someone else’s shoes for how they would want to see and view the information. Having the opportunity to go into patient rooms and observe proper bedside manner and get a firsthand view at how they view chronic pain and alternative treatments was a wonderful opportunity. Being able to connect public health, health promotion, and all that I have learned in my undergraduate career into a real life setting is thrilling and shows that all my hard work has paid off. Even though I am almost halfway through with this internship, I am excited to see what awaits me.

1. 1.4.2 Prioritize health education and promotion needs
   • Ensuring that all materials created and research conducted is at the benefit of the patients within the office and is educational in nature and will help them in the areas of pain management and alternative methods to treating and living with chronic pain.
2. 5.2.5 Identify available resources and gaps
   • Seeing what materials are currently available to patients and creating new materials on underserved areas. Additionally, this can include observing clinical visits and seeing what areas patients need the most educational materials in.
3. 5.3.1 Use media to conduct advocacy
   • Creation of health education materials for the office within the areas of pain management and understanding what chronic pain is
4. 7.1.3 Involve partners and stakeholders throughout the health education and promotion practice
   • Regularly communicating and having conversations with Dr. Thomas about my work and receiving and implementing his professional and experienced input. Interacting with practice patients to observe and hear their needs firsthand to tailor my work towards them.

June 15, 2026: Today started like off like every other day with my morning conversation with Dr. Thomas. We went over what this week is going to look like in terms of my work and the office as a whole. I told him that today I would be spending my time creating the educational brochure for self management of chronic pain. I already had a majority of the resources and research collected and gathered, This meant I had to properly explain it in simple terms, ensure consistency in font type and size throughout the brochure, place it in a way that if the reader only skims it over they got the most information possible, and create a ‘cover page’ to entice the patients to grab the brochure. It took some time finding the correct template, but I was able to find one that was blue and cream. Enough to stand out, not enough to overwhelm the reader. I had to change the font to make it easier to read and more simplistic and change some of the text sizes but I was ready to begin. Most of my time was spent formatting and moving around text boxes, icons, and deciding what font style to use. My next steps involved placing the information on the respective pages/slides of the brochure to find the correct layout. I moved around the layout a few times as I was not quite sure where I wanted certain information. This was also where I had to decide what information was most prominent and what I really wanted and needed the audience to view first, especially if they were only going to skim over the pamphlet. I took a quick break for lunch.

After lunch, I had a conversation with Dr. Thomas and asked him to look over the layout of the educational brochure. He gave me a few pointers and suggestions on the order/layout and I went and corrected these areas. My main section headers were what is chronic pain to give a brief overview, a contact page, a title page, a lifestyle changes suggestion page, setting goals, and self-management strategies. I did not put lots of words on each slide, I know that if I was the intended audience for this project I would not want to read paragraphs upon paragraphs, but I would be looking for bullet points. I also ensured that I kept all language and words simple and at the reading level of someone in middle school. I want to make these materials inclusive for everyone all of reading levels and health literacy levels. As someone working in public health, we want the best for the entire community and focus our work on a broader scale compared to the individual scale. I was able to finish up this educational material and printed out a demo to see how it appeared on paper with the font size and ensuring that all the information aligned with the folding of the pages. After all this, I was heading home for the day.

June 16, 2026: Today I started my day by having a conversation with Dr. Thomas. I informed that today I would spend my time doing exactly what I did yesterday, but the topic for today would be understanding chronic pain. I told him that my plan for tomorrow would be to go into clinical visits with him to show patients the educational materials and receive their direct feedback. He liked this plan and left me to get to work. Since I already had all the research and materials gathered, I just had to do what I did yesterday. This meant picking the correct Canva template, pick the correct font style and size, and making sure the colors are not too bright but enough to be not considered boring or mundane. My next steps involved placing all the information on the respective pages/slides, but I was not yet formatting anything. This step just involved copying and pasting my notes onto the slides to find the correct layout. I did rearrange the order quite a few times. Like I said previously, I am going into this assuming some patients will pick up the pamphlet and either skim through it or only look at the first page. So I needed to position the information in a manner that if this happens they are getting the most important information during their skimming. After all this, I took my break for lunch. 

After lunch, I had Dr. Thomas look over the layout and he agreed with the general placement of information but told me to research the topic a little bit more before I began creating and formatting the pamphlet. He told me to do this since I should try and be the most knowledgeable on a topic before I begin to educate others on it. He said that it wasn’t that I did not know enough, but I should be able to answers any questions that come my way. A way that I learn best is through videos, so I went onto YouTube and watched a few videos on understanding chronic pain and general knowledge surrounding the topic. I also did a few general searches online that involved statistics and numbers within the United States. I had already created the section headers this morning, so I just had to take all the information I had already pasted onto the sides/pages and turned it all into bullet points with easy and simplistic language. I kept it at a middle school reading level again and ensured that the information was straightforward and short and sweet. I did not want to overwhelm the audience nor did I want to give them paragraphs to read, since I would not read that if given to me. I was able to finish this up during the afternoon and sent it over to Dr. Thomas for his approval and if he had any suggestions or pointers. After all this, I was heading home for the day. 

June 17, 2026: Today started like all other days by having a conversation with Dr. Thomas about my two educational brochures I made on Monday and Tuesday and what the plan for today was. We referred back to our conversation earlier in the week on how I would go into patient visits/rooms with him today as I wanted to ask them questions about educational pamphlets and give them a copy to look over and see how they perceived it or if they had any comments or concerns. Some things I would be looking for included if the text size was big enough for the patients to read, if the colors were too bright or distracting, if there were too many words on the pages, and if they could understand the verbiage and if it fit for all levels of health literacy. All of this would allow me the opportunity to see if the educational pamphlets truly fit the audience’s needs and if it was best suited for them. After this, I followed him into office visits for the rest of the morning. 

After lunch, I decided to take all the feedback given to me by patients and analyze it and get it typed up properly. I first started by analyzing the usability metrics, to me this means text size, color, and font style. Essentially, if the patients were able to read the words based on the text styles, this was separate from if they could understand the materials provided. Most patients could read and said this was not an issue, a few asked if the text size could be larger. Another piece of feedback that I had received was some of the text passages may have been too long and wordy, so I would need to refine and shorten some of the bullet points. Almost all of the patients said that they could understand the message I was trying to convey and that there were not too many words that confused them or advanced medical jargon. To the educational materials I had to: increase text sizes, refine my wording and word length, and take another glance through to look for any grammar or spelling errors. After all these changes were made, I was heading home for the day.

June 18, 2026:

Weekly Competencies:
This week my main lesson learned was all about when making educational materials, you need to make them in the viewpoint of the audience. What I mean by this is that when we are designing materials for a specific group, we need to design and format with them in mind. While making these materials, it was also a learning experience for me. I was learning new information and facts that I did not know previously. At the same time, I had to learn and determine how to present this information for my specific audience, which are the patients within the practice. While it can be easy for me to ramble on and write paragraphs upon paragraphs, I also had to learn how to pick out the most crucial information to include in my materials. I had to think, if someone handed me one of these pamphlets I would not want to read several paragraphs but I would want to see bullet points. This week was all about focusing on your community and their needs, which is ultimately what public health and health promotion is all about. 

1. 7.1.3 Involve partners and stakeholders throughout the health education and promotion practice
   • Regularly communicating and having conversations with Dr. Thomas about my work and receiving and implementing his professional and experienced input. Interacting with practice patients to observe and hear their needs firsthand to tailor my work towards them
2. 1.4.2 Prioritize health education and promotion needs
   • Ensuring that all materials created and research conducted is at the benefit of the patients within the office and is educational in nature and will help them in the areas of pain management and alternative methods to treating and living with chronic pain. This also circles back to my weekly reflection and while this is also a learning experience for me, the materials are not created for me but instead for a different audience and I need to prioritize their needs and wants.
3. 5.3.1 Use media to conduct advocacy 
   • The creation of educational materials in the form of pamphlets to educate office patients on understanding chronic pain and managing chronic pain. 
4. 6.1.2 Identify the assets, needs, and characteristics of the audience that affect communication and message design
   • This also circles back to my weekly reflection, but making the materials with one font style and size, simple colors, using simplistic language and not many scientific words, and at the reading level of a middle schooler to make inclusive for all levels of reading and health literacy. 
5. 6.2.1 Describe the intended outcome of the communication
   • To educate office patients and provide additional information about chronic pain, the science behind it, and daily lifestyle changes and habits to help manage their chronic pain.
6. 6.2.3 Identify factors that facilitate and/or hinder the intended outcome of the communication 
   • This can include reading levels and health literacy levels, if someone does not understand ‘scientific and medical’ words they will not be able to understand the material. This is why I used limited medical terms (only when absolutely necessary) and designed it at the reading level of a middle schooler. Additionally, the time and patience of the patient. If they have limited time or simply do not want to read through the brochure they will not pick up or absorb any of the information contained inside. 
     
     

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