www.mobilehealthmap.org 617‐442‐3200 New research shows that mobile health clinics improve health outcomes for hard to reach populations in cost‐effective and culturally competent ways . A Harvard Medical School study determined that for every dollar invested in a mobile health clinic, the US healthcare system saves $30 on average. Mobile health clinics, which offer a range of services from preventive screenings to asthma treatment, leverage their mobility to treat people in the convenience of their own communities. For example, a mobile health clinic in Baltimore, MD, has documented savings of $3,500 per child seen due to reduced asthma‐related hospitalizations. The estimated 2,000 mobile health clinics across the country are providing similarly cost‐effective access to healthcare for a wide range of populations. Many successful mobile health clinics cite their ability to foster trusting relationships. Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves. A communications academic argued that mobile health clinics’ unique use of space is important in facilitating these relationships. Mobile health clinics park in the heart of the community in familiar spaces, like shopping centers or bus stations, which lend themselves to the local community atmosphere.

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

Purpose To describe how racial microaggressions may affect optimal learning for under-represented health professions students. Method The authors conducted focus groups and individual interviews from November 2017 to June 2018 with 37 students at University of California, Davis and Yale University who self-identified as underrepresented in medicine or nursing. Questions explored incidence, response to, and effects of racial microaggressions, as well as students' suggestions for change. Data were organized and coded, then thematic analysis was used to identify themes and subthemes. Results The data showed consistent examples of microaggressions across both health professions and schools, with peers, faculty, preceptors, and structural elements of the curricula all contributing to microaggressive behavior. The 3 major themes were: students felt devalued by microaggressions; students identified how microaggressions affected their learning, academic performance, and personal wellness; and students had suggestions for promoting inclusion. Conclusions The data indicated that students perceived that their daily experiences were affected by racial microaggressions. Participants reported strong emotions while experiencing racial microaggressions including feeling stressed, frustrated, and angered by these interactions. Further, students believed microaggressions negatively affected their learning, academic performance, and overall well-being. This study shows the need for leadership and faculty of health professions schools to implement policies, practices, and instructional strategies that support and leverage diversity so that innovative problem-solving can emerge to better serve underserved communities and reduce health disparities.

Seeking Inclusion Excellence: Understanding Racial Microaggressions as Experienced by Underrepresented Medical and Nursing Students.

Cross-sector collaborations and partnerships are an essential component of the strategy to improve health and well-being in the United States. While their importance is unquestioned, their impact on population health has not yet been fully observed. Cross-sector collaboration also is the second Action Area of the Robert Wood Johnson Foundation’s four-part Action Framework to build a Culture of Health in the United States. This Action Area has three constituent parts or drivers: the number, breadth, and quality of successful cross-sector partnerships; the adequacy of investment in these partnerships; and the adoption of policies needed to support them. In this article we analyze outstanding examples of partnership-driven work. We also study the challenges of how partner sectors outside the formal health system, such as organizations working in the education or housing sectors, can effectively lead collaborations. We identify models of leadership that maximize the potential of all participants. We also prop...

Cross-Sector Collaborations And Partnerships: Essential Ingredients To Help Shape Health And Well-Being

AIM The purpose of this article is to describe a collaborative project designed to recruit and retain students from underrepresented minorities and disadvantaged backgrounds into nursing education. BACKGROUND Ethnic minorities remain underrepresented in the nursing workforce in comparison to the general population. The numbers of minorities enrolled in nursing education programs are insufficient to meet the health care workforce diversity needs of the future. METHOD High school students were provided with a preprofessional education program to prepare them for admission into a nursing program. Retention strategies were implemented for newly admitted and enrolled nursing education students. RESULTS Twenty-one high school students enrolled in a nursing education program. The students enrolled in the nursing education program graduated and passed the licensure examination. CONCLUSION Early recruitment and multiprong retention programs can be successful in diversifying the registered nurse workforce. KEY WORDS Diversity--Nursing Education--Student Retention--Recruitment--Academic--Community Partnership ********** The registered nurse workforce represents the single largest group of health care providers employed in the United States (US Department of Health and Human Services [DHHS], 2010). Of the nearly 3 million RNs residing in the United States, approximately 16.8 percent have been identified as belonging to racial and/or ethnic minority groups. The 16.8 percent constitutes a significant increase when compared to the 7.2 percent identified in 1980, yet Hispanic, black, and American Indians/Alaska natives remain underrepresented in the RN population (DHHS, 2010). In 2000, the National Advisory Council on Nurse Education and Practice issued A National Agenda for Nursing Workforce Racial/Ethnic Diversity as a call to action to address the under-representation of racial and ethnic minorities in the RN workforce (DHHS, 2000). Nearly two decades later, the call to action has not been realized; ethnic minorities remain vastly underrepresented in the nursing workforce relative to their numbers in the general population. Moreover, the numbers of minorities enrolled in nursing education programs are insufficient to meet the health care workforce diversity needs of the future (Phillips & Malone, 2014). This article describes two strategies used to produce a more diverse RN workforce by increasing recruitment and retention efforts and supporting students entering nursing programs through successful matriculation and graduation. The recruitment program exposed 392 high school students to careers in nursing, with a subsequent enrollment of 21 students into nursing education programs. The retention program engaged 185 students enrolled in the traditional baccalaureate nursing (BSN) program to increase matriculation and successful completion of the National Council Licensure Examination for Registered Nurses (NCLEX-RN[R]). NURSING WORKFORCE DIVERSITY FUNDING In 2009, the Department of Health and Human Services Health Resources and Services Administration (HRSA) announced Nursing Workforce Diversity (NWD) funding to increase opportunities for individuals from disadvantaged backgrounds (economic, social, educational, and environmental) and/or racial and ethnic minorities to enter into the nursing profession. Upon receipt of a three-year HRSA NWD grant, the Saint Louis University School of Nursing (SON), a private Jesuit (Catholic) University, set out to increase the number of underrepresented minorities and/or students from disadvantaged backgrounds who enrolled, matriculated, and graduated from the BSN program. To accomplish this goal, the school developed a two-pronged approach: 1) establish a preprofessional educational program that would prepare students for a career in nursing and recruit students into the SON; and 2) develop retention strategies that would culminate in graduation and licensure examination success for admitted and/or enrolled students from the target population. …

A Nursing Workforce Diversity Project: Strategies for Recruitment, Retention, Graduation, and NCLEX-RN Success.

Does race still matter in nursing? The narratives of African-American nursing faculty members

As nursing continues to advance health care in the 21st century, the current shift in demographics, coupled with the ongoing disparities in health care and health outcomes, will warrant our ongoing attention and action. As within all health professions, concerted efforts are needed to diversify the nation's health-care workforce. The nursing profession in particular will be challenged to recruit and retain a culturally diverse workforce that mirrors the nation's change in demographics. This increased need to enhance diversity in nursing is not new to the profession; however, the need to successfully address this issue has never been greater. This article discusses increasing the diversity in nursing and its importance in reducing health disparities. We highlight characteristics of successful recruitment and retention efforts targeting racial/ethnic minority nurses and conclude with recommendations to strengthen the development and evaluation of their contributions to eliminating health disparities.

https://journals.sagepub.com/doi/pdf/10.1177/00333549141291S209

Increasing racial/ethnic diversity in nursing to reduce health disparities and achieve health equity.

Purpose The purpose of this study was to assess nurses' knowledge, perceived self-efficacy, and intended behaviors relative to integrating the social determinants of health (SDoH) into clinical practice. Design and methods A cross-sectional study was completed with 768 nurses working in three hospitals within a large regional healthcare system located in the Midwest. Data were collected using an adapted 71-item SDoH Survey, which measured nurses' confidence in and frequency of discussing the SDoH with patients, general knowledge of the SDoH, familiarity with patients' social and economic conditions, and awareness of their institution's health equity strategic plan to achieve health equity. The institution's health equity strategic plan reflects the organization's commitment to improving the health of individuals and neighborhoods by addressing the SDoH known to influence health status and life expectancy. Finally, participants were asked to describe barriers to incorporating the SDoH into practice along with completing five demographic items. Descriptive statistics were used to describe the findings. Findings Of the 768 respondents, 63% had a baccalaureate degree in nursing and 33.1% reported more than 20 years in nursing. Fifty percent of respondents reported feeling more knowledgeable or confident in their ability to discuss access to care issues with patients compared to the other SDoH. Identified barriers to discussing the SDoH included insufficient time to address identified needs and unfamiliarity with internal and external resources. Respondents stressed the need for interdisciplinary education and collaboration along with more information on the role of social workers. Conclusions Nurses are more confident in discussing certain determinants of health and could benefit from more skill development in discussing SDoH issues and stronger collaborative partnerships to address identified needs. Clinical relevance Findings from the study have implications for supporting the educational and resource needs of front-line nurses employed in hospitals and health systems seeking to address broader societal issues influencing the health status and outcomes of patients and communities.

https://sigmapubs.onlinelibrary.wiley.com/doi/epdf/10.1111/jnu.12584

Integrating the Social Determinants of Health into Nursing Practice: Nurses' Perspectives

https://www.healthpolicyfellows.org/pdfs/Phillips-PDAfromFellowship.pdf

Prescription drug abuse: Problem, policies, and implications

The response to a pandemic crisis requires strong preparedness and an action plan that is well defined yet flexible enough to address the uncertainties that accompany an infectious disease outbreak. Interprofessional collaboration is an integral component when implementing a robust and comprehensive response to such a crisis. As the needs of our academic medical center evolved during the COVID-19 pandemic, the COVID-19 Mobilizer Team used an interprofessional approach to respond to the diverse and complex needs of the organization. Team members included employees deployed from diverse departments such as Physical and Occupational Therapy, Nursing Education, Hospital Operations, and Advance Practice Providers. The team's function transitioned from ensuring compliance with infection control policy and procedure and use of personal protective equipment to ensuring a two way channel of communication between front line staff and the Hospital Incident Command System (HICS) concerning testing and isolation procedures, supplies, visitor restrictions, and staff wellness issues. The Mobilizer Team members became integral contributors to the HICS and provided members of our staff outside of the COVID-19 care units an opportunity to partner with colleagues from professions they may have never worked with and the chance to contribute to the COVID-19 pandemic response.

https://www.tandfonline.com/doi/pdf/10.1080/13561820.2020.1813696

A short report on an interprofessional mobilizer team: innovation and impact during the COVID-19 pandemic.

OBJECTIVES: To identify research priorities addressing COVID-19 that build on the 2019-2022 Oncology Nursing Society (ONS) Research Agenda, in alignment with ONS's mission to promote excellence in oncology nursing and quality cancer care. METHODS A VARIABLES: Priority areas were identified using a multistep approach combining rapid review of the literature; consultation with experts/stakeholders; and review of priorities from other funding agencies, public health, and cancer-focused organizations. RESULTS: The rapid research response team identified five priority areas for research related to COVID-19. IMPLICATIONS FOR NURSING: Oncology nurses are well positioned to address the research priorities and cross-cutting themes identified through this review. The use of innovative methodologic approaches and attention to disparities are necessary to advance cancer care related to COVID-19.

Janice Phillips

Papers

Increasing racial/ethnic diversity in nursing to reduce health disparities and achieve health equity.

Integrating the Social Determinants of Health into Nursing Practice: Nurses' Perspectives

Prescription drug abuse: Problem, policies, and implications

A short report on an interprofessional mobilizer team: innovation and impact during the COVID-19 pandemic.

The Oncology Nursing Society Rapid Review and Research Priorities for Cancer Care in the Context of COVID-19.