Embracing a competency-based specialty curriculum for community-based nursing roles.

The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties.

An assessment of measures of body image, body attitude, acculturation, and weight status among Mexican American women.

PURPOSE: The purpose of this descriptive study was to establish the validity and reliability of the measurement of body image and body attitudes among Mexican American women. DATA SOURCES: Completed measures of height, weight, waist circumference, body mass index, acculturation, body image, and body attitude of 35 U.S.-born Mexican American women between the ages of 18 and 65 years of age. Also included were repeated measures of body image and body attitude and verbatim face-to-face interviews with 13 study participants. CONCLUSIONS: Most study participants were overweight; however, body image discrepancy (difference between perceived actual and ideal body image) did not increase as anticipated and was negatively related to body mass index; suggesting those participants' perceptions of ideal body image increased with increasing body size and was reliable. Body attitude subscale scores had varying relationships to weight status. IMPLICATIONS FOR PRACTICE: Further study is warranted examining why an acceptance of a greater body image occurs, potentially leading to a greater understanding of the influences of body image integration on health behaviors. Clinicians working with Mexican American women should consider weight reduction interventions that are based on an individual assessment of the perceptions of body image and body attitudes.

Regional variations in cancer screening rates found in women with diabetes.

BACKGROUND: A review of the literature gives conflicting findings regarding gender-specific cancer screening rates found in women with chronic illness. OBJECTIVES: The purpose of this study was to determine if women with diabetes have different patterns of cancer screening than women of the general population, and if so, to identify the determinants of these screening patterns guided by the Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model. METHODS: The 12 states using the optional women's health module for the 2003 Behavioral Risk Factor Surveillance System were downloaded into the STATA software. Contingency tables were used to identify the prevalence of cancer screening in women who self-report that they have diabetes in comparison with women who report being nondiabetic. Logistic regression was used to examine the association between the PRECEDE model determinants and the screening behaviors. RESULTS: No significant association was found between having a diagnosis of diabetes and having mammography screening rates (F = 1.5, p =.22). However, cervical cancer screening rates were statistically significantly different between the two groups of women (F = 39.01, p <.01). A gap in cervical cancer screening rates was identified among women with diabetes as compared with women without diabetes (78% versus 86%, respectively). Regional exceptions were noted between the 12 states. Ten of the 11 PRECEDE variables demonstrated a significant association with Papanicolaou test screening rates. The states demonstrating inadequate screening rates were the states with the most negative PRECEDE factors. DISCUSSION: Research has shown that the primary reason women seek cancer screening is when they are encouraged by a healthcare provider. If other care providers are focused on disease management, nurses who provide holistic care can build on the advocacy role inherent in nursing and encourage screening in underserved areas of the country.

Integrating research into teaching public health nursing.

Integration of research into teaching provides an environment for students to not only learn how research is conducted but also experience how research contributes to improving practice and client outcomes. Integrating research into teaching is important because of the need to build evidence for public health nursing practice. This article describes an innovative approach by faculty to integrate research into teaching undergraduate and graduate public health nursing courses. This approach was developed using the Mexican-American Problem Solving research study. The purpose of the Mexican-American Problem Solving study was to develop, test, and refine a home- and school-based nursing intervention to improve family functioning, children's health conceptions, self-esteem, and mental health. Students were involved in all aspects of the study, including focus group sessions, instrument translation, data collection, intervention implementation, and dissemination of the results. The authors describe these activities and provide recommendations for successfully involving students in faculty research.