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A Scoping Review on Childhood Immunization Reminder Strategies Available to Parents in North America
No full textObjective: The scoping review protocol will be used to map out the immunization reminder strategies for parents’ literature to identify the effectiveness of these approaches in improving childhood vaccination uptake.
Introduction: Vaccine-preventable diseases continue to cause morbidity and mortality despite the introduction of childhood immunizations1,2, with recent media alerts showing a surge of common childhood vaccine-preventable illnesses like measles3. Parents can play a pivotal role in ensuring their children receive vaccinations when due4,5,6. However, effective immunization reminders could assist parents who forget or miss the immunization schedules for their children.
Inclusion criteria: The review will include studies conducted between 2004 and 2024 in North America that focus on immunization reminders for parents with children under 6 years. Parents of only adolescents will be excluded.
Methods: The data for the review will be searched from databases such as CINAHL, Medline, and Embase between May 20th, 2024, and August 20th, 2024. Hand-searching of journals and gray literature will be carried out. Qualitative, quantitative, and mixed-methods studies published in English will be eligible for selection if they meet the inclusion criteria. The studies selected for review will then be summarized on a PRISMA chart. A data-extraction form will be used to collate authorship information and publication date, methods, findings, and key arguments with key themes later analyzed using thematic analysis
Disparities in Mental Health and Substance Use Disorder Related Postpartum Readmissions
No full textImportance: Postpartum readmission (PPR) affects up to 3% of all births in the U.S.1,2 PPR is often avoidable, especially for psychiatric disease and substance use disorders.3,4 Many mothers experience challenges accessing mental health and substance use treatment during perinatal periods. Nursing science prioritizes equitable care5 highlighting the critical need to address this public health issue.
Aim: To investigate the intersections of residential rurality and race/ethnicity on all-cause, mental health disorders and substance use disorders (SUD) PPR throughout 1-year postpartum.
Methods: A statewide retrospective cohort study using birth certificates linked to all-payer hospital data for mothers in South Carolina from 2018-2021. Our main exposures were maternal race/ethnicity and rural-urban residence. For administrative censoring, PPR was defined as an inpatient readmission at 4 time points: within 42, 90, 180 and 365 days after initial birth hospitalization discharge using International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) diagnoses and procedure codes. We report Cox proportional hazard ratios (HR) and 95% confidence intervals (CI), adjusted for prenatal (e.g., education) and clinical (e.g., mode of birth) factors.
Results: Of 195,311 mothers, 28,617 (14.6%) resided in rural residential areas. Using urban residence as the reference group, for rural mothers after adjustment, all-cause PPR: HR 1.15 (CI: 1.06, 1.25); mental health related PPR: HR 1.06 (CI:0.93, 1.20); and SUD PPR: HR 1.13 (CI: 0.96, 1.33). In considering the interaction between maternal residence and race/ethnicity using urban and Non-Hispanic (NH) White as the reference group, all-cause PPR in NH Black rural mothers: HR 0.86 (CI: 0.77, 0.96), Hispanic rural mothers: HR 0.53 (CI: 0.33, 0.85); mental health related PPR in NH Black rural mothers: HR 0.92 (CI: 0.75, 1.12), Hispanic rural mothers: HR 0.45 (CI: 0.11, 1.87); for SUD PPR in NH Black rural mothers: HR 0.98 (CI: 0.76, 1.26), and Hispanic rural mothers: HR 0.59 (CI: 0.08, 4.44).
Conclusions: Rural mothers have a higher risk of all-cause related PPR, yet differences specific to mental health and SUD PPR among this group were less apparent. Rurality interacts with race/ethnicity to influence all-cause PPR rates, where NH Black and Hispanic mothers in rural areas show a reduced risk. Nurses should prioritize discharge planning to consider the distinct needs of rural mothers at increased risk
Facilitators & Barriers to Self-Management of T2D in Elderly Black African and Afro-Caribbean People
No full textBackground: Self-management helps to reduce the rate of morbidity, mortality and healthcare costs associated with uncontrolled diabetes due to various complications such as neuropathy, retinopathy and nephropathy. Ageing increases the risk of developing health conditions such as Type 2 Diabetes (T2D), and there is a global increase in the number of people living longer. Older adults who are from ethnic minority backgrounds in the United Kingdom (UK) are placed at a greater disadvantage, as their financial situation, employability, and social networks are gravely lower than that of their White Counterparts. Additionally, there is a paucity of research focusing on the elderly Black African and Afro-Caribbean people (BAACP) with diabetes in the UK.Aim: This study aims to explore the barriers and facilitators to self-management of type 2 diabetes in Elderly BAACP living in London from a multi-perspective standpoint.Methods: A qualitative study with a phenomenological approach will be used to conduct a four phase study. Purposive sampling and snowballing techniques will be used to recruit participants for all the phases of the research. Interviews and focus groups will be used to collect data from elderly BAACP with T2D, healthcare practitioners, family members, and community leaders following appropriate ethical approval. A verbatim transcription will be done, and the transcribed data will be analysed thematically. NVivo computer software will be utilised in the data analysis process.Conclusion: The study will provide an understanding of the challenges of T2D management among the Elderly BAACP living in the urban city of London. Furthermore, it is anticipated that the study will provide insight into the role of family members/ social support in managing T2D in these individuals. This will assist in creating a culturally sensitive intervention that can inform better healthcare practices and policies
Identifying Neurological Conditions: A Virtual Reality Simulation for Critical Care Nursing Students
No full textBackground: Virtual reality (VR) has become one of the most useful tools in nursing education because it allows simulation for active learning that requires interaction and provides an authentic, standardized, safe experience for students (Kiegaldie & Shaw, 2023). Moving difficult content from a didactic setting to a VR experience opens a new opportunity for a more meaningful learning experience.Purpose: The purpose was to create a standardized neurological virtual reality (VR) simulation using the Virti platform for senior level nursing students in a traditional BSN program to achieve three primary objectives. Identify signs and symptoms of decreased level of consciousness due to increased ICP, select appropriate assessment interventions related to the patient’s medical condition, and assess and recognize the signs and symptoms of Cushing’s Triad.Method: Students are scheduled in groups of 20 - 25 and provided VR headsets. The simulation begins with report then students are prompted to assess the patient followed immediately by a question posed by faculty then followed by a multiple-choice question. As the simulation unfolds each assessment requires a confirmation question. If a question is answered incorrectly, an automated video of faculty appears and provides additional information then the student is re-routed back to the question. Each student is scored for this formative assessment after completion of the simulation then students are given a 30 minute debrief lecture by faculty to clarify any confusing concepts and review the simulation.Results: Formative feedback from 200 students immediately following simulation debrief showed 99.5% of students Strongly Agreed/Agreed that “After completion of the VR neuro simulation I am more confident in my neurological assessment skills”. Summative results showed an average improvement on three exam questions since beginning the VR simulation. Exam question scores increased for identification of Cushing’s Triad, and increased ICP, and ICP treatment by 13%, 4%, and 47% respectively
Faith-Based Transitional Care Model (TCM) Clinic: Pilot Project
No full textHospital readmission rate is highest among underserved communities. Providing continuum of care to these populations will yield a greater reduction in readmission rate. Church and faith-based clinics often help underserved communities. Equipping them with the transitional care model (TCM) and an Advanced Practice Registered Nurse (APRN) with specialized training as a Faith Community Nurse (FCN) can implement whole-person care and reduce hospital readmission and improve the health of the community. Monterey County has a readmission rate of 13.4%. Only one out of four community hospitals has a transitional care department only for diagnoses specified in the Hospital Readmissions Reduction Program (HRRP). The Project Lead offered an educational session to the 17 health ministry members, church leaders, and other stakeholders of the local community church in Monterey County, Salinas, California. The session introduced the Health Ministry Association, history and philosophy of health ministry, examples of spiritual care, and covered key concepts such as FCN, TCM, and whole-person care. An anonymous survey assessed participants’ demography and overall satisfaction with the educational offering. A knowledge assessment tool, created by Dr. Ziebarth, an expert in faith community nursing and transitional care was given before and after the educational offering. The pre-test results were used as a baseline, and the post-test results assessed how much the participants attained knowledge.
The project anticipated a 20% increase in knowledge and a post-intervention pass rate of 80%. Scores less than 80% were remediated by reviewing the contents and allowing the participants to retake the test. After the educational session, 15 participants completed the pre- and post-test. The one-tail t-test result was 0.0023 (p-value set to 0.05), which was significant even before the remediation of the seven people who scored below 80%. After remediation, the one-tail t-test result was 0.0001
Validation of the Affiliate Stigma Scale for Asian Indian American Dementia Family Caregivers
No full textBackground/Purpose: The Affiliate Stigma Scale is a commonly used instrument for measuring stigma experienced by caregivers of persons with intellectual disabilities and mental illness (Mak & Cheung, 2008). It is particularly relevant within the Asian Indian community, where dementia may sometimes be considered a punishment for past life sins of the patient or their loved ones (Chenug et al., 2019; Hossain & Khan 2019; Hussain et al., 2024; Krishnamurthi et al., 2022). Building on prior work to culturally adapt the affiliate stigma scale for Asian Indian American dementia family caregivers, this study aims to assess the reliability and validity of the culturally adapted scale.
Methods: Psychometric properties of the culturally adapted 22-item Affiliate Stigma Scale were evaluated in a convenience sample of 222 Asian Indian dementia family caregivers living in the United States. Participants were recruited via personal and professional networks using email, social media, and flyers posted in adult senior centers, religious centers, ethnic grocery stores, community clinics, and cultural events. Data were collected using digital and paper surveys. Analyses included descriptive analysis of sample characteristics, reliability, confirmatory factor analysis, and construct validity of the culturally adapted instrument.
Results: A total of 222 Asian Indian American family caregivers of people living with dementia participated. The culturally adapted instrument had excellent reliability (Cronbach’s alpha = 0.96). After the initial exploratory factor analysis, confirmatory factor analysis revealed strong to moderate item relationships with the stigma construct (factor loading range 0.573 to 0.832) and supported a one-factor solution. Construct validity was established, with stigma scored being higher among females, South Indian origin, and those with a formally diagnosed family member.
Conclusion & Implications: The adapted scale demonstrates strong reliability and validity, meeting standard psychometric criteria to provide meaningful and accurate results. The culturally adapted instrument is important for future research and clinical assessment of affiliate stigma in Asian Indian American dementia family caregivers. In nursing education, these findings can inform the development of culturally tailored programs to raise awareness of affiliate stigma among caregivers and healthcare professionals, helping caregivers recognize and address stigma in their cultural context
Motivation to Lead and its Contributing Factors Among Black Registered Nurses: A Literature Review
No full textBackground: Strong evidence reveals that a more diverse U.S. healthcare workforce enhances care delivery, promotes culturally responsive care, expands access to healthcare, and helps reduce disparities among underrepresented populations.1 The limited presence of Black nurses in frontline leadership roles has a profound impact on nursing and healthcare, limiting opportunities to improve resources, attract diverse talent, and maintain a workforce that reflects the communities it serves.2 The extent to which Black nurses are motivated to lead is not known.
Purpose: The purpose of this literature review was to understand the prevalence of motivation to lead among Black nurses, its contributing factors, and knowledge gaps.
Methods: A literature search was conducted using the electronic academic databases CINAHL, EBSCOhost, PubMed, and PsycINFO. Criteria for the search included primary sources, English only, and peer-reviewed articles from the last ten years to understand the depth and breadth of motivation to lead among Black nurses. Nineteen empirical papers are included in the literature review, including 1 mixed-method, 6 quantitative, and 12 qualitative peer-reviewed publications.
Results: This review identified a limited number of quantitative and qualitative studies exploring nurses’ leadership motivation in acute care settings. Quantitative research indicated a moderate to high prevalence of leadership motivations among nurses; however, only one study included Black nurses in its sample.3 Qualitative studies focusing on Black nurses highlighted workplace racism and a lack of mentorship as significant barriers to leadership opportunities.4 Additionally, quantitative findings emphasized leadership self-efficacy as a key factor influencing nurses’ motivation to lead.5
Conclusions/Implications: The studies show that motivation to lead is moderate to high among samples predominantly composed of White nurses.3 A significant gap in the research was the underrepresentation of Black nurses in study samples. Factors such as workplace racism, leadership self-efficacy, and mentorship may be important factors associated with Black nurses’ motivation to lead. Quantifying and examining the impact of these factors is essential to gaining insights and developing strategies that support, empower, and prepare Black nurses for frontline leadership roles
Client and Clinician Priorities for Same-Day PrEP and Doxy-PEP Awareness, Uptake, and Persistence in Primary Care
No full textApproximately 70% of all new human immunodeficiency virus (HIV) infections are among populations of sexual and gender minorities (SGM) and are primarily attributable to sexual contact. Currently, only 26% of the U.S. population who would benefit from HIV preexposure prophylaxis (PrEP) are prescribed this effective biomedical HIV prevention strategy. Biomedical prevention strategies for bacterial sexually transmitted infections (STI) like doxycycline postexposure prophylaxis (doxy-PEP), are a vital component to the successes of ending the HIV epidemic given the well-known association between STIs and risk for HIV infection. In this multiple methods study, we leveraged group concept mapping and conducted focus groups with identified stakeholder groups (e.g., SGM clients and primary care clinicians) to (1) Describe approaches from SGM client perspectives that facilitate awareness, uptake, and persistence of biomedical prevention (same day PrEP & doxy-PEP) in the primary care setting, (2) describe approaches from primary care clinician perspectives that facilitate awareness, uptake, and persistence of biomedical prevention (same day PrEP & DoxyPEP) in the primary care setting and (3) identify the joint priorities of clients and clinicians (high-feasibility and high-importance) for the integration of same day PrEP and doxy-PEP in primary care. The analysis revealed six distinct clusters representing critical aspects of how to effectively increase the use of PrEP and doxy-PEP specifically within the primary care context, and 49 strategies were rated highly for both importance and feasibility, emphasizing areas like providing non-judgmental information to patients about PrEP during routine visits, increasing SGM affirming clinicians, and providing a welcoming environment. Notably, an emphasis on educating health professionals on both biomedical prevention and SGM health needs emerged as a critical component. This research provides a framework for understanding and implementing biomedical prevention supports in the primary care space. Future research should focus on the practical application and continued evaluation of these strategies and biomedical prevention uptake in primary care
Beyond Fertility
No full textPolycystic Ovary Syndrome (PCOS) is a multifaceted and chronic endocrine disorder, affecting approximately 8–13% of women of reproductive age globally (Teede et al., 2018). It is characterised by clinical and/or biochemical hyperandrogenism, menstrual irregularities, insulin resistance, and polycystic ovarian morphology (Azziz et al., 2016). Beyond reproductive implications, PCOS is associated with long-term risks including type 2 diabetes, cardiovascular disease, and significant psychological distress (Lizneva et al., 2016).Although PCOS affects approximately 8–13% of women of reproductive age globally (Teede et al., 2018), the diagnostic experience of Black women is marked by prolonged delays, inadequate referrals, and substandard care. These patterns are not merely clinical oversights; they are produced and sustained by implicit bias, racialised assumptions about pain tolerance and resilience, and the gross underrepresentation of Black women in reproductive and endocrine research (Williams et al., 2021; Azziz et al., 2016). Consequently, PCOS remains a significantly under-recognised and mismanaged condition within this population, leading to long-term metabolic, reproductive, and psychological consequences
Cultivating Psychological Safety: Harvesting Success for Newly Licensed Nurses
No full textHear about strategies within a transition to professional nursing practice program which foster a psychologically safe environment designed to support nurses during their first year post-licensure. Participants should expect to learn about how incorporating human skills (otherwise known as soft skills) can improve teams\u27 resiliency and trust.
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