Showing papers in "Public Health Nursing in 2002"
TL;DR: Although CHWs show some promise as an intervention, the role can be doomed by overly high expectations, lack of a clear focus, and lack of documentation, so further research is required with an emphasis on stronger study design, documentation of CHW activities, and carefully defined target populations.
Abstract: Community health workers (CHWs) are promoted as a mechanism to increase community involvement in health promotion efforts, despite little consensus about the role and its effectiveness. This article reviews the databased literature on CHW effectiveness, which indicates preliminary support for CHWs in increasing access to care, particularly in underserved populations. There are a smaller number of studies documenting outcomes in the areas of increased health knowledge, improved health status outcomes, and behavioral changes, with inconclusive results. Although CHWs show some promise as an intervention, the role can be doomed by overly high expectations, lack of a clear focus, and lack of documentation. Further research is required with an emphasis on stronger study design, documentation of CHW activities, and carefully defined target populations.
477 citations
TL;DR: Seven key elements found in a literature review to be beneficial in establishing church-based community health promotion programs that demonstrated desired health promotion outcomes are proposed and one program that embodies these elements is presented.
Abstract: Although not a new concept, church-based health promotion programs have yet to be widely researched. Few of the initial studies used randomized and controlled designs. Dissemination of study results has been sporadic, with findings often reported in church periodicals. A renewed interest in church-based health promotion programs (CBHPP) is emerging. The purpose of this article is to propose seven key elements found in a literature review to be beneficial in establishing church-based community health promotion programs that demonstrated desired health promotion outcomes. Based on the outcomes of successful CBHPP, the following key elements have been identified: partnerships, positive health values, availability of services, access to church facilities, community-focused interventions, health behavior change, and supportive social relationships. An example of one program that embodies these elements is presented. The Heart and Soul Program, designed to increase physical activity in midlife women to reduce their risk of cardiovascular disease with advancing age, is discussed within the context of the elements for successful church-based programs. CBHPP have effectively promoted health behaviors within certain communities. To promote health and wellness in light of our diverse society and health needs, health promotion professionals and churches can be dynamic partners.
253 citations
TL;DR: This review examined the intervention research literature testing strategies to increase activity among African American women and found common methodologic weaknesses included lack of randomization of subjects, single-group design, instruments without documented validity and reliability, significant attrition, and questionable timing of outcome variable measurement.
Abstract: The lack of routine physical activity among African American women places them at risk for negative health outcomes associated with inactivity. The number of studies focused on African American women has increased dramatically in the past decade. This review examined the intervention research literature testing strategies to increase activity among African American women. Eighteen studies with 1,623 subjects were retrieved. Diverse interventions, settings, and measures were reported. Common methodologic weaknesses included lack of randomization of subjects, single-group design, instruments without documented validity and reliability, significant attrition, and questionable timing of outcome variable measurement. Strategies to design and deliver culturally appropriate interventions are reviewed. Suggestions for future research, such as examining intragroup differences and communal resources, are provided.
183 citations
TL;DR: Investigating factors and beliefs that may be related to the practice of breast self-examination among a group of Jordanian women found confidence, motivation, susceptibility, and fewer barriers were variables that showed a positive association with BSE practice in the previous year, while benefits, susceptible, and motivation influenced the intention to perform BSE in the future.
Abstract: The purpose of this cross-sectional, correlational, descriptive study was to investigate factors and beliefs that may be related to the practice of breast self-examination (BSE) among a group of Jordanian women. The sample consisted of 519 women from two major universities in Jordan. About 36% of the sample were university employees and 64% were graduate and undergraduate students. Stratified random sampling was used to enroll the undergraduate students while graduate students and employees were selected by convenience sampling. The study instrument was an adapted version of Champion's Revised Health Belief Model Scale (CRHBMS). The results were analyzed using a chi-square test and a stepwise multiple regression. The main findings indicate that although the majority of the sample population (67%) had heard/read about BSE, only a quarter of them reported that they had ever practiced BSE in the previous 12 months, and only 7% had performed it on a regular monthly basis. Confidence, motivation, susceptibility, and fewer barriers were variables that showed a positive association with BSE practice in the previous year, while benefits, susceptibility, and motivation influenced the intention to perform BSE in the future. Women's age, level of education, having heard or read about breast tumors, and personal history of breast tumors were also found to be significant predictors of BSE practice.
174 citations
TL;DR: A model for organizing the complex web of factors associated with household composition and late-life migration is proposed and key areas for nursing research and strategies for applying available research are identified.
Abstract: The living arrangements of older persons play a key role in their use of formal and informal care, as well as in their health and well-being. Nurses engaged in primary care, discharge planning, and home care are strategically positioned to contribute to an optimal fit between older persons and their home environment. This article describes the demographic significance of late-life living arrangements and proposes a model for organizing the complex web of factors associated with household composition and late-life migration. The article then summarizes qualitative and quantitative evidence in support of the proposed model. Key areas for nursing research and strategies for applying available research are identified.
143 citations
TL;DR: The investigator suggests that public health nurses can enhance their case management strategies when working with the parents of children with developmental disabilities by monitoring for caregiver burnout in addition to ensuring that the child is receiving care appropriate for his or her level of need.
Abstract: Respite child care programs that provide temporary child care, support, and referral services to families of children with developmental disabilities are thought to be a critical component of formal social support interventions deemed necessary to promote healthy family functioning and prevent child maltreatment. This study describes sociodemographic characteristics, parenting stress levels, foster care placement, and founded child maltreatment rates in families of children with developmental disabilities who were using respite care services in a rural Midwestern state. Comparison of matched pre- and post-test Parenting Stress Index scores indicated significant decreases in Total Stress scores (t=3.27, df=86, p=0.0016), Parent Domain scores (t=3.55, df=86, p=0.0006), and Child Domain scores (t=2.2, df=86, p=0.02) following provision of respite care. Through logistic regression, it was determined that life stress, social support, and service level were significantly related to the occurrence of child maltreatment during enrollment ( p < 0.05). The investigator suggests that public health nurses can enhance their case management strategies when working with the parents of children with developmental disabilities by monitoring for caregiver burnout in addition to ensuring that the child is receiving care appropriate for his or her level of need.
118 citations
TL;DR: The greatest need for assistance was associated with transportation or interactions that involved speaking English, and the assistance offered was viewed as highly satisfactory, while participants were least satisfied with the help they received for diabetes-related self-care, personal care, and financial assistance.
Abstract: The rising incidence of diabetes mellitus continues to be a major health concern among Hispanic Americans. Social support has been found to be a relevant factor in diabetes self-management, however, it has not been explored within a Hispanic community. This cross-sectional study was therefore conducted with 95 insulin-requiring Hispanic adults to explore the composition of the support network, the type of assistance needed, the degree of satisfaction with support received, and the relationship between social support and diabetes self-management. Overall, the participants had fairly large networks, composed primarily of family members. The greatest need for assistance was associated with transportation or interactions that involved speaking English, and the assistance offered in these areas was viewed as highly satisfactory. Participants were least satisfied with the help they received for diabetes-related self-care, personal care, and financial assistance. Social support was not strongly related to diabetes self-management. Community health nurses must be aware that this population may have needs that are unsatisfactorily met. They should provide education and resources for support persons and carefully evaluate the support network, not only for availability, but also for satisfaction. Effort should also be directed toward developing alternative support for those without available family.
105 citations
TL;DR: The impact of environmental factors and caregiver attitudes on exercise participation in adults with cerebral palsy using a social-cognitive model was examined and non-nursing home residents were more likely to exercise than nursing home residents.
Abstract: This study examined the impact of environmental factors and caregiver attitudes on exercise participation in adults with cerebral palsy using a social-cognitive model The sample included 83 adults with cerebral palsy (470% males and 530% females) Hierarchical regression analysis was conducted with exercise frequency as the dependent variable Independent variables included personal characteristics of persons with cerebral palsy (age, level of mental retardation, health status, mobility, and arm/hand limitation), type of residence, exercise facility access, and caregiver-perceived benefits of exercise for people with cerebral palsy The significant determinants of exercise participation were the caregiver's perceived benefits of exercise for persons with cerebral palsy and the type of residence When caregivers perceived greater benefits of exercise, adults with cerebral palsy were likely to exercise more frequently Non-nursing home residents were more likely to exercise than nursing home residents This difference was related to differences in the caregivers' perceived benefits of exercise and not because of the personal characteristics of the residents or access to the exercise facility Results of this study point to the need to inform and educate caregivers about the benefits and importance of exercise for adults with cerebral palsy
101 citations
TL;DR: This study showed poor practices of healthy lifestyles of elderly Korean immigrants and low exercise scores indicated the need for community based exercise and health promotion programs for the elderly Korean immigration population.
Abstract: The purpose of this study was to explore health-promoting behaviors among elderly Korean immigrants, and to examine the relationships of their health-promoting behaviors with self-efficacy and perceived health status. One hundred ten elderly Korean immigrants residing in the United States were interviewed using a structured questionnaire. The mean score of health promoting behaviors of elderly Korean immigrants was 2.54 on the 5-point Likert scale. Nutrition was the subdomain with the highest mean score (M=3.01) and exercise was the subdomain with the lowest mean score (M=1.92). Both self-efficacy (r=0.49, p=0.01) and perceived health status (r=0.19, p=0.043) were significantly related to health-promoting behaviors. Education (F=3.61, p=0.016) and economic status (F=3.01, p=0.034) were significantly associated with health-promoting behaviors. This study showed poor practices of healthy lifestyles of elderly Korean immigrants. Low exercise scores indicated the need for community based exercise and health promotion programs for the elderly Korean immigrants population.
96 citations
TL;DR: Whether a relatively brief and inexpensive clinic-based education program could benefit parents of infants and toddlers by alleviating parental stress and improving parent-child interaction is evaluated.
Abstract: Community-based parent education programs are a common component of service plans for abusive and potentially abusive parents. Despite their widespread use, few studies have evaluated the effect of such programs to change actual parenting behavior even though this is a key intervention goal. The purpose of this study was to evaluate whether a relatively brief and inexpensive clinic-based education program could benefit parents of infants and toddlers by alleviating parental stress and improving parent-child interaction. Participants were 199 parents of children 1 through 36 months of age who were at risk for parenting problems and child maltreatment due to serious life stress including poverty, low social support, personal histories of childhood maltreatment, and substance abuse. Program effects were evaluated in terms of improvement in self-reported parenting stress and observed parent-child interaction. Positive effects were documented for the group as a whole and within each of three subgroups: two community samples and a group of mothers and children in residential drug treatment. Additional analyses illustrated a dose-response relationship between program attendance and magnitude of gain in observed parenting skills.
95 citations
TL;DR: An interactive computer program designed for the learning styles and psychomotor skills of older adults was used to teach older adults about potential drug interactions that can result from self-medication with over-the-counter (OTC) agents and alcohol.
Abstract: An interactive computer program (Personal Education Program [PEP]) designed for the learning styles and psychomotor skills of older adults was used to teach older adults about potential drug interactions that can result from self-medication with over-the-counter (OTC) agents and alcohol. Subjects used the PEP on notebook computers equipped with infrared sensitive touchscreens. Subjects were recruited from senior centers. Those who met age, vision, literacy, independence, and medication use criteria were randomly assigned to one of three groups: (1) PEP plus information booklet; (2) information booklet only; or (3) control. A repeated measures (three time periods 2 weeks apart), three-group design was used. Users of PEP had significantly greater knowledge and self-efficacy scores than both the conventional and control groups at all three time points. The PEP group reported fewer adverse self-medication behaviors over time. Reported self-medication behaviors did not change over time for either the conventional or control groups. Subjects indicated a high degree of satisfaction with the PEP and reported their intent to make specific changes in self-medication behaviors.
TL;DR: The roles of Japanese nurses in the field of home care are presented in the context of the historical perspective and view for the future and four issues ofHome care in Japan are described related to home care for older persons, high-tech home care, terminal care, andHome care for psychiatric patients.
Abstract: Home care in Japan has developed over the past 30 years. Nurses have taken leadership in promoting home care and at the same time have expanded their roles. The roles of Japanese nurses in the field of home care are presented in the context of the historical perspective and view for the future. Home care nurses have performed care management for their community as well as for individual older clients living in their community. Currently, nurses work as high-tech and personal care providers and are developing a new role in health care enterprises. The number of nurses working as clinical nurse specialists will increase consistently with the rapid increase of master's programs. In the future, nurses should take a lead in developing health policy. The purpose of the article is to describe the current situation of home care clients and home care nursing in Japan. In addition, four issues of home care in Japan are described related to home care for older persons, high-tech home care, terminal care, and home care for psychiatric patients.
TL;DR: A central goal of the project was for the services developed during its course to be assimilated into the regular programming of the Chicago Department of Public Health, a goal that was achieved.
Abstract: This report describes a 4-year long bilingual interdisciplinary primary health care project that was designed to make culturally sensitive services available to underserved Korean immigrants in Chicago. It also describes some of the particular needs of this population and the strategies that the project staff adopted to identify and address the population's mental health needs. The project reflected the successful collaborative efforts of four participating principals: the Korean community, the University of Illinois at Chicago College of Nursing, the Chicago Department of Public Health, and the W. K. Kellogg Foundation. The model of service demonstrated in the project paired a bilingual advanced practice nurse, a certified family nurse practitioner, with a bilingual community advocate to conduct a program emphasizing community outreach and health promotion and prevention. A bilingual physician provided consultation for the nurse and attended to patients in need of medical care. Patients were referred to bilingual community social service agencies for assistance with a variety of other problems. A central goal of the project was for the services developed during its course to be assimilated into the regular programming of the Chicago Department of Public Health, a goal that was achieved. Finally, some of the challenges of introducing role change into an organization are discussed.
TL;DR: Mobile medical programs have the potential to improve STD and HIV control efforts by providing services to high risk individuals who may lack access to care elsewhere, however, will require more active case finding techniques, including new, less invasive techniques to test asymptomatic individuals.
Abstract: This retrospective study assesses the efficacy of a mobile medical van in screening high risk individuals and identifying new cases of HIV and other sexually transmitted diseases (STDs) in an urban setting from July 1996 through March 1997. High risk sex and drug use were common, while consistent condom use was rare. Relatively few patients were screened for STDs; positive cases represented only a small proportion of the STD cases identified in the study community. The mobile program, however, accounted for 11.5% of all HIV tests conducted at public test sites in the city. Mobile medical programs have the potential to improve STD and HIV control efforts by providing services to high risk individuals who may lack access to care elsewhere. Doing so, however, will require more active case finding techniques, including new, less invasive techniques to test asymptomatic individuals.
TL;DR: In this article, the authors identify factors that influence whether disabled Mexican American elders decide to use skilled home care nursing (SHCN) services less often than Anglo elders and identify seven barriers to the use of SHCN services: expectations of discrimination, lack of knowledge about services, expectations embedded in familism and lack of sense of prevention.
Abstract: Hispanic elders use skilled home care nursing (SHCN) services less often than Anglo elders. The purpose of this study was to identify factors that influence whether disabled Mexican American elders decide to use SHCN services. The research process included reviewing the historical context in one Mexican American community, interviewing key and primary informants, presenting a report to the community and getting feedback, and assessing whether the community perceived a need for increased use of SHCN services by their disabled elders. Seven barriers to the use of SHCN services were identified: expectations of discrimination, lack of knowledge about services, expectations embedded in familism, lack of sense of prevention, lack of health insurance, preference for traditional remedies, and neglect/abuse. A community advisory committee validated the barriers identified during interviews and the need for increased use of SHCN services. Results provide new insight into the sociopolitical and cultural complexities that influence health care utilization decisions by Mexican American elders and their families and uncover traditional, oversimplified beliefs and practices by mainstream professionals and policymakers. Interventions that decrease inequities in a southern Arizona community may be transferable to other vulnerable populations in the United States and globally.
TL;DR: To address the known difficulties of incorporating new priorities into established practice, nurses attending an environmental health short course participated in a nominal group process focusing on the question, "What specific actions can the authors take to bring environmental health into the mainstream of nursing practice?"
Abstract: :Nurses are increasingly the primary contact for clients concerned about health problems related to their environment In response to the need for nursing expertise in the field of environmental health, the Institute of Medicine (IOM), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute of Nursing Research (NINR) have designed core competencies for the nursing profession The IOM competencies focus on four areas: (1) knowledge and concepts; (2) assessment and referral; advocacy, ethics, and risk communication; and (4) legislation and regulation The competencies establish a baseline of knowledge and awareness in order for nurses to prevent and minimize health problems associated with exposure to environmental agents To address the known difficulties of incorporating new priorities into established practice, nurses attending an environmental health short course participated in a nominal group process focusing on the question, "What specific actions can we take to bring environmental health into the mainstream of nursing practice?" This exercise was designed to bring the concepts of the national initiatives (IOM, NINR, ATSDR) to the awareness of individual nurses involved in the direct delivery of care Results include 38 action items nurses identified as improving awareness and utilization of environmental health principles The top five ideas were: (1) get environmental health listed as a requirement or competency in undergraduate nursing education; (2) improve working relationships with interdepartmental persons-a team approach; (3) strategically place students in essential organizations such as NIOSH, ATSDR, or CDC; (4) educate nurse educators; and (5) create environmental health awards in nursing The 38 original ideas were also reorganized into a five-tiered conceptual model The concepts of this model include: (1) developing partnerships; (2) strengthening publications; (3) enhancing continuing education; (4) updating nursing practice; and (5) strengthening schools of nursing The model serves as a road map for action in building environmental health capacity within mainstream nursing
TL;DR: This study discusses how social structures of isolation, investment in a medical discourse, and processes of normalization construct an individual's experiences and practices of mothering, which in turn influence pedagogical practices in postpartum classes.
Abstract: This qualitative study, which was conducted in the summer of 1992, presents the findings of how six first-time mothers and two public health nurses experienced pedagogical practices within postpartum classes offered by two public health units in Ontario, Canada. How concerns and aspirations of new mothers were constructed and mediated in the postpartum class are analyzed using concepts from poststructuralist and feminist methodologies. This study goes beyond an analysis of individual teaching and learning styles and discusses how social structures of isolation, investment in a medical discourse, and processes of normalization construct an individual's experiences and practices of mothering, which in turn influence pedagogical practices in postpartum classes. Issues of empowerment, language, support, and knowledge exchange are discussed.
TL;DR: Interventions may need to be tailored for different risk groups within Black populations of adolescent girls, as Black girls who had less problem solving skill than their peers were five times more likely to have early intercourse and three times morelikely to practice fewer health-promoting behaviors.
Abstract: This study examined the extent to which problem solving self-image and other health-related factors predict age at first intercourse among Black and White adolescent females. The volunteer sample was 16 to 19 years old; 52% were Black (n=105) and 48% (n=97) were White. Adolescents were recruited from family planning clinics throughout South Carolina. Stratified analyses identified race as a modifier of the relationship between problem solving and time of first intercourse (early or delayed). Logistic regression revealed three predictors of early age at first intercourse in Black girls but only one predictor in White girls. There were no race differentials in either age or the proportion of girls initiating early intercourse. However Black girls who had less problem solving skill than their peers were five times more likely to have early intercourse three times more likely to practice fewer health-promoting behaviors and seven times more likely to have 10 or fewer years of education. Early intercourse was significantly associated with unprotected first intercourse. Our findings suggest that interventions may need to be tailored for different risk groups within Black populations of adolescent girls. (authors)
TL;DR: The process of team building, role release through a transdisciplinary approach, and a nurse's role on a transciplinary assessment team are explored.
Abstract: Assessing young children with disabilities is a complex process requiring the expertise of a team of professionals from several disciplines. Team members often include the child's family members, early childhood special educators, clinical psychologists, speech-language pathologists, social workers, physical and occupational therapists, pediatricians, and nurses. A team approach meets standards of best practice in early childhood intervention and encourages full family participation in the assessment process. This article explores the process of team building, role release through a transdisciplinary approach, and a nurse's role on a transdisciplinary assessment team.
TL;DR: Nurses need to plan educational programs in all settings to teach older clients about the risk factors, prevention, diagnosis, and treatment of osteoporosis.
Abstract: With an increased focus on wellness and health promotion, there is a need for community-based strategies to complement traditional strategies aimed at improving individual and aggregate health. An educational program on the prevention, diagnosis, and treatment of osteoporosis was provided for 188 women age 60 and older in three different community settings: churches, retirement homes, and senior citizen centers. The major purposes of the study were to determine whether a community-based program might (a) contribute to older women's knowledge about osteoporosis and (b) promote their intent to use this knowledge. Each participant completed a demographic profile, the Osteoporosis Risk Checklist, and the Osteoporosis Knowledge Questionnaire (OKQ), with the OKQ serving as a pre- and post-test. Before post-testing, a 30-min educational program was provided. Differences among the three groups were risk factors, prior knowledge about osteoporosis, and knowledge at the completion of the program. A majority of the clients indicated an intent to increase calcium in their diet, discuss osteoporosis with their health care provider, check their home environment for safety/falls, and discuss what they had learned with others. Nurses need to plan educational programs in all settings to teach older clients about the risk factors, prevention, diagnosis, and treatment of osteoporosis.
TL;DR: This research employed a participatory approach to explore environmental health concerns among Lac Courte Oreilles Ojibwa Indians in Sawyer County, Wisconsin and found concern for environmental issues was high in this tribal community, especially for future generations.
Abstract: This research employed a participatory approach to explore environmental health (EH) concerns among Lac Courte Oreilles (LCO) Ojibwa Indians in Sawyer County, Wisconsin. The project was grounded in a broad ecological conceptualization of EH and in principles of health promotion and community participation. Community participation was accomplished through a steering committee that consisted of the primary author and LCO College faculty and community members. The selected assessment methodology was a self-administered survey mailed to LCO members in Sawyer County. Concern for environmental issues was high in this tribal community, especially for future generations. Concern was higher among older members and tribal members living on rather than off the reservation. Local environmental issues of concern were motorized water vehicles, effects from global warming, aging septic systems on waterways, unsafe driving, and contaminated lakes/streams. The LCO community can use survey results to inform further data needs and program development.
TL;DR: Clients perceived having a parish nurse as positive and beneficial for individuals, the congregation, the church, and community, and parish nurses were viewed as effective and meaningful health providers.
Abstract: The purpose of this study was to examine parish nursing from a client's perspective.Parish nursing is a relatively new health delivery model that has rarely been investigated. In order to describe the client perception, an ethnographic approach was used. The convenience sample included clients from two congregations in a southeastern Appalachian area served by parish nurses. Face-to-face client interviews were conducted, and the Spradley's ethnographic approach to data analysis of transcripts was used. Each interview was analyzed separately by the research group for patterns and meanings reflecting the emic perspective. Five themes of client perception of parish nursing emerged from the data: (1) being available, (2) integrating spirituality and health, (3) helping us help ourselves, (4) exploring parish nursing, and (5) evaluating parish nursing.Clients perceived having a parish nurse as positive and beneficial for individuals, the congregation, the church, and community. Parish nursing was viewed as a useful, meaningful, and effective health intervention and setting, and parish nurses were viewed as effective and meaningful health providers. Further exploration of the effectiveness of this nursing delivery model is warranted.
TL;DR: The purpose of the project described in this article was to explore how community mobilization strategies could be used to improve the health of pregnant women in the Punjabi community.
Abstract: In Canada, although prenatal education is available to all women, there are groups who do not access these services. One such group is Immigrant Punjabi women residing in the Lower Mainland of British Columbia. It was apparent that structured prenatal education, even when translation was available, would not meet the needs of this group. Efforts were required to help bring this issue into the community so that the community would endorse women's participation in prenatal preparation. The purpose of the project described in this article was to explore how community mobilization strategies could be used to improve the health of pregnant women in the Punjabi community. A collaborative approach was used with representatives from a variety of service agencies and the community. The mobilization strategy involved creating a platform to communicate with the community about prenatal health and health care, creating "buy-in" from the physicians serving the women of the community, and providing prenatal sessions that built on the existing knowledge of the women. We describe the mobilization process and discuss the insights gained.
TL;DR: The community-based Athens-Clarke County Sexual Assault Nurse Examiners program was developed to respond to the needs of sexual assault victims, and nurses are well equipped to provide forensic examinations in a caring, out-of-hospital environment.
Abstract: The community-based Athens-Clarke County Sexual Assault Nurse Examiners (ACC-SANE) program was developed to respond to the needs of sexual assault victims. Although this type of SANE model allows for a strong nurse-managed program, there are frustrations and pitfalls that differ from most hospital-based programs. At this time, the majority (71%) of SANE programs are based in hospitals, and few (15%) function in outpatient/community facilities. In the ACC-SANE program, many community agencies interact to provide a seamless approach to postassault health care, counseling, and criminal prosecution. SANE nurses are well equipped to provide forensic examinations in a caring, out-of-hospital environment. The program is housed in a remodeled cottage that rests on property owned by the Athens-Clarke County government and that is adjacent to the local police department. ACC-SANE is governed by a nonprofit board of directors. This management model has allowed the original organizing groups to remain active in the development of the program. As these agencies continue in the governance of the program, they remain committed to the success of ACC-SANE. The impact of program growth and published program guidelines is examined.
TL;DR: The need for community health nurses to design dietary interventions tailored for women's stage of readiness for change to reduce disability in this vulnerable population of older women is suggested.
Abstract: Poor diet is one of the factors that influences morbidity and premature mortality among older women. The purpose of this descriptive correlational study was to assess (a) healthy eating behaviors of midlife and older rural women, as reflected by adherence to the Dietary Guidelines for Americans, and (b) differences in daily servings in each food group consumed by the women across stages of readiness for change in healthy eating. A sample of 371 midlife and older rural women attending a national meeting of a community education organization completed a questionnaire, including items to measure healthy eating and readiness for change in healthy eating. Only 5.9% of the women adhered to all levels of the Food Pyramid. Adherence to individual levels ranged from 3.5% for grain products to 65.4% for fruit. Analyses of variance revealed significant differences (p < 0.05) in servings consumed daily across stages of change for grain (F=4.80), fruits (F=19.02), vegetables (F=9.24), dairy (F=2.45), and meats (F=1.98). Findings suggest the need for community health nurses to design dietary interventions tailored for women's stage of readiness for change to reduce disability in this vulnerable population.
TL;DR: The authors examine issues and problems that resulted from the blending of two models of practice-stabilization/crisis intervention and early intervention/health promotion-and describe the outcome-based evaluation that was used to assess initial and ongoing child development, parent-child interaction, family environment, and social support.
Abstract: This article presents an evaluation of an in-home support program for at-risk mothers and their children. The program was multidisciplinary and was focused on development of parenting capacity and child-development competencies. The authors examine issues and problems that resulted from the blending of two models of practice-stabilization/crisis intervention and early intervention/health promotion-and describe the outcome-based evaluation that was used to assess initial and ongoing child development, parent-child interaction, family environment, and social support. When documentation and evaluation of practice and its effect on outcomes proved a considerable challenge, the authors developed a classification system to describe practice in three areas: situations addressed, interventions used, and referrals made. The article describes challenges surrounding program development, implementation, and evaluation.
TL;DR: The literature related to the importance of nutrition for cognitive and physical abilities in children support the hypothesis that maternal education, perceived family resources, andThe importance of family routines would be related to children's dietary patterns.
Abstract: A correlation study was designed to test the hypothesis that maternal education, perceived family resources, and the importance of family routines would be related to children's dietary patterns. Additionally, the study examined the hypothesis that dietary patterns would be associated with children's cognitive and physical abilities. The sample for this study included 159 African American single-mother families with a 6- to 9-year-old child living in rural areas, most of whom lived in poverty. Children's eating patterns were assessed using a self-report questionnaire administered to the mother in an interview format. Children's cognitive ability was measured by several subscales from the Woodcock Johnson Psycho-Educational Instrument and the Harter Perceived Competence Scale for children. For male children, the mother's higher education was related to more adequate eating patterns at home, and more perceived family resources were related to the likelihood of taking vitamin supplements. For female children, greater milk intake was positively related to cognitive outcomes, including applied problem, passage comprehension, calculation, synonym identification, antonym identification, and quantitative concept scores. Milk intake was clearly related to more optimal cognitive development. The results of this study support the literature related to the importance of nutrition for cognitive and physical abilities in children.
TL;DR: The task for PHN is to recognize and to dialogue about these complexities so that nursing's voice can be heard as solutions to these dilemmas are created.
Abstract: Public health is increasingly joining forces with managed care, yet the effect of this partnership on public health nursing (PHN) has received little scrutiny. The feasibility and consequences of a public-private alliance raise questions about whether the mission of public health can be sustained in a managed care system and whether managed care's approaches to health care are conducive to providing population-oriented care. Expanding the links between PHN and private organizations is both problematic and promising. Managed care organizations have much to offer, including coordination of services and comprehensive care. However, they may also restrict coverage and create bureaucratic obstacles to obtaining services. The growth of for-profit health care corporations evokes questions about ways in which concern for communities and populations collide with stockholder interests. The task for PHN is to recognize and to dialogue about these complexities so that nursing's voice can be heard as solutions to these dilemmas are created.
TL;DR: Nurses whose clients were more likely to continue until goals were met were higher in conscientiousness, learned more from experience, and learned less from coworkers or learning on their own.
Abstract: The purpose of this study was to examine the relationship between nurse and client characteristics and the reason for client termination from public health nursing maternal and child home visits. The results indicate that clients who dropped out of services received more contacts from the nurses, missed more appointments with the nurses, and were given advice from the nurses on more topics. They also differed from clients who continued with services until the nursing care plan goals were met in reference to marital status, mental illness, source of payment for services, and use of WIC and food stamps. Nurses whose clients were more likely to continue until goals were met were higher in conscientiousness, learned more from experience, and learned less from coworkers or learning on their own. They also worked more hours per week. These findings have implications for practice and research.