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Interventions to Optimize Dietary Patterns in Black Pregnant Individuals: An Integrative Review
No full textBlack pregnant individuals bear an inequitable burden of maternal morbidity and mortality and adverse fetal outcomes.1 Behavioral factors including dietary patterns2 and adverse social determinants of health (SDOH) influence these disparities. Nutrition and diet quality are modifiable risk factors that can reduce pregnancy-related complications including cardiometabolic disease.1 The objective of this integrative review is to identify and evaluate research exploring interventions to optimize dietary patterns in Black pregnant individuals.This review was reported based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses. A comprehensive electronic database search was conducted. Inclusion criteria: full-text articles on intervention studies among pregnant individuals in high-income countries, at least 50% of study population identified as Black or African American. Exclusion criteria: nonscientific articles, study populations with diabetes, invasive gastric surgery, exclusively postpartum. Constant comparison analysis3 was conducted on: publication year, location, sample, setting, study design, intervention details, dietary assessment method, and primary study outcome. Articles were appraised via the Joanna Briggs Institute4,5 and Consolidated Standards of Reporting Trials6 tools.Twelve articles from eight studies were eligible. All included articles were favorably appraised. Four studies included Black or African American participants exclusively;7–12 four studies included individuals with obesity or overweight exclusively.9–14 Study design, interventions, and primary outcomes varied across articles. Participant demographics and dietary patterns were inconsistently reported. Use of 24-hour diet recall or investigator-developed dietary assessment questions occurred in five studies.7,9,10,14–18 Only two articles included changes in diet quality as a primary outcome or reported post-intervention changes in diet quality.15,17The paucity of articles eligible for this review demonstrates continued underrepresentation of Black pregnant individuals in research and highlights the need for interventions to optimize dietary patterns in this population. Future research should prioritize robust reporting of participant demographics, SDOH, and dietary patterns, and increased representation individuals of diverse race, ethnicity, and body composition
Nurse Strong: Building Resilience Through De-Escalation
No full textIn 2015, the American Nurses Association called upon nursing faculty to develop and create workplace violence prevention programs. In response to the ANA, our innovative educational experiences show how the implementation of scaffolded experiences in self-defense, de-escalation, and leadership within an accelerated nursing program better prepares students for the realities of practice. In healthcare, especially in fast-paced settings, nurses often face challenging situations that require quick decision-making, conflict management, and assertive leadership to maintain safety for all. Workplace violence continues to increase in prevalence in the healthcare setting. Scaffolding—a progressive, structured approach to skill development—enables students to build foundational skills in self-defense and de-escalation and then apply them in increasingly complex and realistic simulations. By starting with basic techniques and gradually introducing dynamic, high-stress scenarios, students learn to manage their physical and emotional responses effectively. The incorporation of leadership skills emphasizes situational awareness, patient advocacy, and clear communication, which are essential for managing crises. The project evaluates the impact of scaffolded training on nursing students’ confidence, situational adaptability, and ability to lead under pressure. Data collected from summative student feedback, observation, and performance assessments indicate that scaffolded experiences in education significantly enhanced students’ readiness for real-world clinical challenges, particularly those involving potential conflict. Findings suggest that scaffolded simulation is a valuable educational strategy, equipping students with both the interpersonal and leadership skills required to maintain safety and provide quality care
Health Coaching Intervention to Increase Nursing Student Resilience, Self-Compassion, and Well-Being
No full textThere is a nursing shortage in the United States, with worsening projections over the next ten years. Reasons for the shortage are multifactorial and include both individual and institutional causes. A majority of nurses express feelings of stress, fatigue, and frustration which contribute to burnout and leaving the profession, worsening an already pressing problem. Nursing students are entering a complex healthcare field that they may be unprepared for. They experience stressors in school that may even prevent them from completing school and entering the profession. Seeing the need to address this issue while students are in the throes of their nursing studies, a health and wellness coaching option for students was implemented as a component of a second semester nursing clinical course. Health and wellness coaching is an intervention that uses evidence-based practices to promote positive change and support participant well-being. Over the last several years offering health and wellness coaching to second semester nursing students, surveys demonstrate satisfaction with coaching. A one-time, lump sum donation to the School of Nursing has provided a mechanism for students to continue coaching beyond the second semester should they desire to do so. The current research study quantitatively assess the effect of health and wellness coaching on participants’ well-being, resilience, and self-compassion as well as determining if there is a dose-related effect, i.e., does more health coaching improve those measures? The purpose of this study is to examine the effect of a health and wellness coaching intervention on the resilience, well-being, and self-compassion of undergraduate nursing students. The question for this research is: Does participating in health and wellness coaching increase resilience, well-being, and self-compassion for baccalaureate nursing students? The overall aim of this initial research study is to improve resilience, well-being, and self-compassion in undergraduate nursing students. Future studies will include following undergraduate students into the nursing workforce and expanding the research to include graduate nursing students with the overarching goal of preventing/reducing nurse burnout and nurses leaving the profession
Factors Influencing Health-Promoting Behaivors of Adults in Cambodia
No full textPurpose: Cambodia is with NCDs responsible for 64% of deaths in 2018. Health-promoting behaviors play a vital role in reducing the risk of NCDs. The aims of the study is to identify the determinants of health-promoting behaviors among adults living in Cambodia.
Methods: A cross-sectional study was conducted, and through stratified sampling, 268 adults aged 19 years or older residing in Phnom Penh participated. A structured questionnaire was used. The Health-Promoting Lifestyle Profile II questionnaire was used to assess health-promoting behaviors across six subscales. Data analysis was performed using the SPSS version 23.0.
Results: A total of 267 adults participated. The regression analysis showed that age, marital status, education level, perceived health status, diagnosis of hypertension or diabetes, risk perception (benefit and cue to action), and general self-efficacy were significantly associated with overall HPB (F = 15.011, p \u3c .001), explaining 50% of the variance (adjusted R square = .500). Subcomponent analysis revealed distinct patterns across health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management. Education level, perceived health status, benefit perception, cue to action, and general self-efficacy were significant predictors across multiple subcategories. Notably, benefit perception and cue to action were consistently associated with higher levels of physical activity (β = .17), nutrition (β = .27), spiritual growth (β = .23), interpersonal relations (β = .22), and stress management (β = .26). General self-efficacy also emerged as a significant predictor for health responsibility (β = .16), physical activity (β = .15), spiritual growth (β = .27), interpersonal relations (β = .29), and stress management (β = .17). The model’s explanatory power across subcomponents ranged from 25.5% to 45.3%.
Conclusion: The study demonstrates that education level, perceived health status, NCD-related perceptions (benefit and cue to action), and general self-efficacy are significant predictors of health-promoting behaviors among adults in Phnom Penh. The findings suggest that psychosocial and demographic factors play substantial roles in influencing various dimensions of health-promoting behaviors. These insights underscore the importance of targeted interventions focusing on enhancing self-efficacy, risk perception, and educational support to improve health outcomes in low-resource settings
C.A.R.E. Symposium and Caritas: Co-Creating Community Engagement to Advance Health Equity
No full textThe foundation of nursing lies in the art of caring, addressing emotional, spiritual, and psychosocial health beyond the physical. Jean Watson\u27s Theory of Human Caring and the eighth Caritas Process, Co-Create, which focuses on creating healing environments at all levels, offers a guiding framework for nurses, healthcare providers, survivors, and community members to bridge divides created by social drivers of health, such as those perpetuated by human trafficking.The inaugural C.A.R.E. Symposium: An Anti-Trafficking Movement offered a platform to address the global health crisis of human trafficking. It provided a collaborative space for community members and advocates to promote health equity through a holistic approach to care. Grounded in the C.A.R.E. mentality—Capacity, Allyship, Resilience, and Equity—the symposium focused on creating environments where survivors, those vulnerable to exploitation, and others affected by trafficking feel supported in healing.Participants reflected on their roles in fostering such environments in clinical, community, and societal contexts. The symposium highlighted how integrating holistic care with community advocacy drives collective action and systemic change. Through dynamic presentations and collaborative discussions, attendees gained the tools to confront human trafficking and advance health equity.Focusing on Co-Create, the eighth Caritas Process, the symposium emphasized nurturing physical, emotional, and spiritual spaces to foster resilience for individuals and communities alike. The event set a precedent for future collaborations on public health crises and demonstrated how integrating holistic care with community engagement can promote enduring health equity for all
Stay Curious! Building Professional Development through The Center for Nursing Inquiry
No full textPurpose: The purpose of this presentation is to describe the capacity building measures to increase engagement in scholarly activities through the Center of Nursing Inquiry (CNI).
Background: Literature indicates providing education, supportive leadership, dedicated time, mentoring and resources are effective methods to increase capacity and engagement in evidence-based practice (EBP), quality improvement and research1,2,3,4,5. Health system leadership approved a center tasked to use evidence-based strategies and dedicated resources to meet organizational priorities through nursing inquiry.
Methods: The CNI launched in 2018 to serve a globally recognized six-hospital health system. The CNI leads multisite research and provides education including workshops, videos, podcasts, a journal club, office hours, EBP education cohorts and a Nurse Scholar Fellowship. Additional initiatives, such as social media presence, listservs, a robust website and a system nursing conference, facilitate recognition and dissemination.
Results: The CNI has produced over 59 podcasts (1030 plays) and 46 videos (7500 views). The 2024 conference featured 70 presenters and 750 participants. Over 50 nurses have joined EBP education cohorts and 32 Nurse Scholars have been trained due to dedicated time to participate. In FY24 nurses in the health system published at least 79 articles, delivered 102 conference presentations, and conducted 16 research studies, 97 QI and 18 EBP projects.
Implications: The successes of the CNI show dedicated resources and leadership support are effective in empowering nurses to engage in inquiry work, further their professional development, contribute to science, and support strategic priorities
Does Journal Writing Reduce Stress and Depression in Parents of a Critically Ill Child?
No full textBackground: An estimated 230,000 children are admitted to the Pediatric Intensive Care Unit (PICU) annually in the United States. A child’s critical illness is stressful for the entire family, causing significant emotional distress among parents. The PICU experience can lead to the development of clinical distress and anxiety in parents following patient discharge. Journal writing is an intervention that has been effective for improving mental health outcomes in various populations. Several meta-analyses show small to moderately sized beneficial effects in improving depression, stress, and PTSD symptoms in the general population. Recently, there has been more interest surrounding the use of parent journals in pediatric critical care. One researcher found that the majority of parents whoused the journal recommended it for other parents. They did not find any difference in stress scores between the experimental and control group, however, their group size was small.
Specific Aims: The aim of this study is to describe whether journal writing reduces stress and depression in caregivers of children admitted to the PICU.Methods: A quasi-experiemental 2 group design was used. Caregivers are recruited from the PICU at a large freestanding children’s hospital in the Pacific Northwest. After answering baseline questionnaires, they are allocated to the journal writing intervention group (n = 18) or control group (n = 15). Caregivers in the intervention group are given a journal and asked to write in the journal at least 4 times/week for at least 10 minutes, while the control group receives standard nursing care. Both groups receive surveys at stress, depression surveys at baseline, discharge, and at 3 months after discharge.Results: Data collection is in progress. Recruitment started 5/20/24.Discussion: Caregivers whose child is admitted to the PICU are at risk for developing anxiety, stress, and PTSD after discharge. Interventions to improve the mental health of caregivers in the PICU are limited. Journal writing is a simple and cost effective intervention that nurses can offer families upon admission and does not require additional nursing time other than explaining the journal to the family. The results of this study will add to the body of knowledge related to interventions that may improve parent mental health
Managing Dementia Behavioral Symptoms: Informal Caregivers’ Experience and Needs
No full textBackground: Eighty-three percent of persons with Alzheimer\u27s disease and related dementias (Pw-ADRD) rely on informal caregivers—mainly family and friends—for at-home care. In 2023, over 11 million dementia caregivers provided an estimated 18.4 billion hours of unpaid care, valued at $346.6 billion [1]. Although there is a wealth of literature on the roles of dementia informal caregivers, there is little data on their ability to manage the behavioral symptoms experienced by approximately 90% of Pw-ADRD [1], as well as the resources they utilize for support [2]. These symptoms have been positively correlated with functional and cognitive impairment leading to earlier placement in nursing homes, increased use of emergency services, increased caregiver burden [3]. Studies have shown that non-pharmacological interventions can prevent and manage those symptoms [3-4]. However, significant disparities persist in the quality and accessibility of support to caregivers for at-home care due to the social determinants of health, such as income, education, and healthcare access, which have a significant impact on the quality of care that the caregivers provide and increase their burden [5].
Purpose: To explore the experiences of informal caregivers in relation to sources of knowledge and initiated strategies for managing the behavioral symptoms of dementia.
Method: This was a qualitative phenomenological study. In-depth interviews with 15 consented dementia informal caregivers, The collected data was analyzed using thematical analysis.
Findings: Three key themes were revealed: (1) Managing behavior symtoms challenges, (2) Credibility of online information, and (3) Lack of real-time, personalized support and guidance. Additionally, the findings showed that training programs and support group meetings often require caregivers to memorize and retain information, which can be overwhelming.
Implications: The findings highlight the importance of empowering informal caregivers by providing them 24/7 access to personalized, evidence-based interventions for managing behavioral symptoms. Nursing professionals can play crucial role in offering tailored, easily accessible, round-the-clock information resources and guidance. By addressing the social determinants of health, registered nurses can advocate for improved care systems for underserved populations, ultimately empowering caregivers and enhancing the quality of care for Pw-ADRD
The Newborn Oral Microbiome, Intrapartum Antimicrobials, and the Microbiome-Centric Nurse
No full textPurpose: The purpose of this presentation is to describe the oral microbiome findings of newborns with and without exposure to intrapartum antimicrobials and how nurses can interpret and apply microbiome findings through microbiome-centric practice.
Background: The newborn phase is a critical period of development and may serve as the foundation for lifelong health.1 At birth, newborns acquire microorganisms that colonize the body to form the microbiome. The introduction of intrapartum antimicrobials at this stage may affect newborn oral microbiome colonization.2-5
Methods: This secondary data analysis describes the 16s rRNA sequencing data from 19 newborn oral swabs and compares the findings based on exposure to intrapartum antimicrobials. This data was collected during the CLearance of the AIRways study and was used with permission. In this sample, five newborns were not exposed to intrapartum antimicrobials, five were exposed to antibiotics only, and nine were exposed to antibiotics and disinfectants. The most prevalent phylum and family-level bacterial findings are examined.
Discussion: This analysis reveals the presence of a previously unreported bacterial family, Erysipelotrichaceae. Some family-level bacterial abundances in this study support the existing literature while others represent novel findings. Through the evaluation of these bacterial findings, nurses will begin to consider the microbiome as a body system and a microbiome-centric approach to practice will be discussed
Community Building in Group Antenatal Care: A Scoping Review and Conceptual Framework
No full textIn US-based studies, group antenatal care (GANC) is associated with lower risk for prematurity and low birth weight and improved mental health; and resulted in higher satisfaction with care for clients and providers.1,2 Evidence from recent clinical trials globally found that GANC improve key outcomes, including facility birth, antenatal and postpartum care attendance, quality of care, breastfeeding, and health literacy.3–8 In GANC, cohorts of 8-12 pregnant clients attend their ANC visits together. Centering-inspired GANC models adhere to three core components: healthcare in a group space, interactive learning, and community building.8–10 However, community building is poorly understood.The purpose of this study is to explore the evidence on community building as a core component of GANC and develop a conceptual framework. In doing so, this will create a a foundational understanding of the component and better understand its impact on outcomes.A search of published research on GANC or group well-childcare was conducted using multiple databases, that resulted in 4,239 articles. After screening and review, data were extracted using Covidence and analyzed using atlas.ti.11 Quality assessments were conducted using Critical Appraisal Skills Programme checklists.12 Expert consultations were conducted.Ninety-three (n=93) studies met eligibility and included qualitative (n = 65), quantitative (n = 37), mixed methods (n=) and reviews (n =11). The studies were conducted globally, with the majority in high-income countries (n = 68) with few in low-income countries (n = 19) The studies explored theoretical aspects of community building, including facilitation requirements to enhance community building, and participants’ experience of community building. Group dynamics, relationship building among peers and providers, and social support provided by the group are important building blocks of community building. A conceptual framework for community building in group care was developed by the identified themes.The conceptual framework provides guidance and advances understanding of factors that influence community building among GANC participants and providers. With the expansion of group antenatal care models in the US and globally, the findings from the study provide critical insights into community building, one of the key components of GANC and essential for adapting and scaling this innovative intervention