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Understanding free or reduced-price school meal stigma: A qualitative analysis of parent perspectives
No full textProspective evaluation of plasma proteins in relation to surgical endometriosis diagnosis in the Nurses’ Health Study II
Get PDFThe influence of burnout, resilience, and resources to support clinical practice among newly licensed nurses intended job plans
No full textHarnessing quantum gradient machine learning to decode subtelomeric methylation in telomere maintenance pathways
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Harnessing diet and gene expression insights through a centralized nutrigenomics database to improve public health
No full textImproving health behaviors and symptoms in youth with mental health disorders: The GamerFit RCT
No full textObjective We tested GamerFit, a theory-based health coaching and exergaming intervention delivered via mHealth app for feasibility and preliminary efficacy to improve physical activity (PA), sleep, perceptions of barriers and support, and mental health outcomes in youth with heterogeneous/comorbid mental health disorders (HCMHD). Methods A convenience sample of youth ages 13–17 with HCMHD were recruited via clinical referral, listservs, and media platforms. The primary outcome of feasibility was assessed relative to the original intervention, which was not delivered via mHealth app. Groupings were randomized 1:1 to the 12-wk GamerFit intervention arm (GamerFit) or active comparator arm (AC) using single-blind design to assess preliminary efficacy. GamerFit participants used the mHealth app and a Fitbit™ to follow a progressive exergaming and gamified step program. AC participants were given PA/sleep tips and Fitbit™ to track PA/sleep. Intervention feasibility was assessed for the GamerFit group using process data and parental/participant report; PA duration/intensity (actigraphy, self-report), sleep duration/quality (actigraphy, self-report), sleep hygiene, perceptions of social support, self-regulation, positive/negative affect, and global quality of life were measured at wks 0, 12 and 16. Mixed effects linear models were used to account for the repeated measures correlation over time with an unstructured covariance matrix. The covariates in the model included the main effect for time and treatment as well as the interaction of these effects. Results 62 participants were randomized (15.0 ± 1.5 avg age, 24 % female-identifying, 21 % non-white, 74 % on medication). GamerFit averaged 88 % coaching attendance, 34.8 min/wk exergaming, and 8033 steps/day, exceeding the original intervention\u27s feasibility benchmarks for coaching attendance and steps per day, but not exergaming minutes per week. Parental/participant acceptability/accessibility was high. Days/wk of PA increased significantly in GamerFit vs. AC (diff 2.0 ± 0.9, 95 % CI, p = 0.04). GamerFit significantly improved sleep hygiene, sleep quality, barriers to exercise, emotional and informational support, affect, and reduced unhealthy days; AC did not. GamerFit showed clinically meaningful improvements on all self-regulation sub-scales; AC did not. Conclusions GamerFit shows promise to improve health behaviors and outcomes among youth with HCMHD. An effectiveness RCT should take place in a more racially/ethnically diverse population
Reducing Stigma Through School Meals for All Programs: New Evidence From Eight U.S. States
No full textObjectives: School meals are the healthiest food source for US children, yet stigma around free or reduced-price meals often hinders participation. School Meals for All (SMFA), also known as universal school meals, may improve children’s nutritional status and school social dynamics, but whether these policies effectively alleviate stigma remains unclear. This study examines whether embarrassment about school lunch predicts participation and how SMFA policies relate to stigma across household income levels. Methods: A cross-sectional, natural experiment was conducted in eight states (four with SMFA, four without) during the 2022–2023 school year. Surveys from 1,066 middle and high school students assessed frequency of school meal participation and embarrassment about school lunch. Generalized estimating equations accounted for state-level clustering, examining associations between embarrassment and participation, and testing SMFA’s influence on stigma. Results: Embarrassment was linked to lower meal participation, particularly among those eligible for free or reduced-price meals (FRPM). Embarrassed FRPM-eligible students participated 20% less often (Rate Ratio = 0.80, 95% CI: 0.71–0.93). SMFA policies were associated with a 27% reduction in embarrassment in FRPM-eligible students (Adjusted Odds Ratio = 0.73, 95% CI: 0.59–0.89), whereas higher-income students in SMFA states were more likely to report embarrassment (aOR = 2.22, 95% CI: 1.85). Overall, 11.5% of students reported embarrassment about eating school lunch. Conclusions: Stigma, measured as embarrassment, is a significant barrier to school meal participation for low-income students. While SMFA policies may reduce embarrassment among these students, they could inadvertently increase stigma among higher-income peers. Addressing perceptions of school meals is crucial for maximizing the potential of universal school meal programs to promote equitable nutrition and health outcomes. Funding Sources: This study was funded by California General Fund SB 170
Influence of Nurse’s Knowledge and Attitudes on Caring Behaviors for People with Opioid Use Disorder
No full textBackground: Opioid use disorder (OUD) remains the leading cause of preventable substance use-related deaths in the U.S. Each year, more than 1 million Americans seek hospital care for OUD-related issues. However, they often receive inadequate treatment and face barriers such as limited overdose prevention education, delays in medication initiation, and insufficient post-discharge follow-up. Nurses are well-positioned to improve inpatient OUD treatment, yet qualitative research suggests they often have limited knowledge and negative attitudes toward OUD, which can decrease the level of compassion and empathy nurses have toward people with OUD. Validated instruments, such as the Care Behavior Index (CBI-6) and Drug and Drug User Problems Perceptions Questionnaires (DDPPQ), can be used to assess the relationship between nurses’ knowledge and attitudes and the level of care nurses provide people with OUD. This study examined the relationship between nurses’ knowledge/attitudes and caring. Additionally, we further examined differences in DDPPQ and CBI-6 scores by nurse’s demographic and work-related factors. Method: A cross-sectional study was conducted from September 16th to December 10th, 2024 at two Tufts Medicine hospitals in Eastern Massachusetts. Approximately 600 nurses are employed in the adult inpatient units of these hospitals. Nurses were recruited through emails, newsletters, and targeted in-person outreach to nursing leadership. The survey was collected online via REDcap. Participants demographics, work-related factors, knowledge and attitudes (DDPPQ), and caring behaviors (CBI-6) were measured. Simple linear and generalized linear model regression analyses were conducted to examine the relationship between DDPPQ and CBI-6 scores, adjusting for relevant covariates. Results: Two hundred twenty-four nurses started the survey. A total of 125 nurses completed the entire survey and were included in the analysis (94% female, 82% white, 98% non-Hispanic, mean age 35 ± 11.69) years). Nurses’ perceived knowledge and attitudes were significantly associated with caring behaviors (β = –0.11, p \u3c 0.0001), with higher DDPPQ scores (decreased knowledge and more negative attitudes) linked to reduced caring behaviors. Multiple workplace factors were associated with variations in nurses’ knowledge/attitudes and caring behaviors. However, holding an RN license was the only significant factor contributing to the relationship between knowledge/attitudes and caring. Conclusion: Nurses’ knowledge and attitudes play a crucial role in shaping their caring behaviors toward people with OUD. Although multiple workplace factors were associated with nurses’ knowledge/attitudes and caring. The possession of an RN license was the only significant workplace factor contributing to the relationship between knowledge/attitude deficits and reduced caring. Given persistent gaps in hospital-based care and the growing prevalence of OUD, there is an urgent need for targeted interventions at both individual and organizational levels to improve nurses’ knowledge and attitudes and support the delivery of evidence-based compassionate care for people with OUD. Further research should explore how specific workplace factors influence nurse’s knowledge, attitudes, and training needs related to the care of people with OUD
