Integrating population health into nursing education: The process of gaining commitment from Washington's nursing deans and directors.

The achievement of health equity requires the expansion of nursing roles to include assessing burdens of disease, practicing cultural humility, implementing prevention strategies, and developing partnerships. In 2017, deans and directors of schools and programs of nursing in Washington State came together to commit to the integration of population health concepts and social determinants of health into all areas of nursing curricula. Through online communications and in-person meetings, facilitated in part by the authors of this paper, and with subcommittee representation from several baccalaureate nursing programs, Washington State academic nursing leaders identified new strategies to increase faculty awareness of population health and how to inspire related curricular changes to their programs. This Washington-wide initiative resulted in a white paper that was formally endorsed by 38 deans and directors representing all 14 baccalaureate and higher degree nursing programs in the state.

Stigma resulting from head lice infestation: A concept analysis and implications for public health.

AIM: The aim of this concept analysis was to examine stigma in the context of head lice, illuminating its components and providing insights for the development of appropriate nursing interventions. BACKGROUND: Stigma associated with the phenomenon of head lice management is pervasive, promulgating fear and influencing policy and treatment practices. Few studies have examined stigma in this context. METHOD: The method followed was the Rodgers's evolutionary method. DATA SOURCES: Health, education, and social sciences databases were searched and yielded 20 articles spanning 1996-2018 used to create a relevant literature review. RESULTS: Stigma arising from head lice infestation is preceded by an actual or perceived case of head lice, negative perceptions of lice, negative perception of groups or persons with head lice, or being associated with a group or person of lesser status believed to be a carrier of head lice. Defining attributes include marks of infestation, negative and unfair beliefs, and shame. Consequences of stigma are economic costs, social costs, mistreatment, and overtreatment with pediculicides. CONCLUSION: The concept of stigma in the context of head lice management is multifaceted. Further research is required to understand the magnitude of stigma as well as other factors associated with optimal treatment of children with head lice.

Development and Evaluation of an iPad Application to Promote Knowledge of Tobacco Use and Cessation by Pregnant Women.

We describe the development and evaluation of an iPad application to promote knowledge of tobacco risk and cessation resources for pregnant women. Pregnant women completed a survey on tobacco use in pregnancy, and clinicians reviewed their tobacco cessation practices and resources. The women reported that content was easy to understand (98%) and helped them understand tobacco risks (94%). Tobacco users reported that the information helped them want to quit smoking (75%) and provided ideas on how to quit (58%). Clinicians reported themes that reflected ease of use, support of pregnant women, and use of electronic resources. We conclude that iPad applications and other electronic health education delivery methods are useful tools that can augment coordinated and consistent tobacco cessation efforts in clinical settings.

Review of Prenatal Maternal Mental Health and the Development of Infant Temperament.

OBJECTIVE: To present a systematic review of literature and evaluate effects of prenatal maternal depression and anxiety on the development of infant temperament. DATA SOURCES: A literature search for studies published between January 1981 and January 2017 was undertaken using the electronic databases PsycINFO and PubMed, as well as reference lists from select resources. Search terms included variations on infant temperament, prenatal/pregnancy, depression, mood, and anxiety. STUDY SELECTION: Studies were included if researchers measured psychological distress during pregnancy as indicated by maternal depression, anxiety, pregnancy-specific anxiety, or a combination of these factors in relation to the development of infant temperament (i.e., parent report or laboratory observations of temperament from 1 to 12 months). In total, 34 articles met inclusion criteria. DATA EXTRACTION: Authors, year of publication, country of origin, sample information, methods, timing, and applicable results were summarized and compared across studies. DATA SYNTHESIS: No standardized data analysis was conducted because of methodologic differences across the identified studies. Of the 34 identified studies, 22 included an indicator of depression (11 with significant results), 26 included an indicator of anxiety (14 with significant results), and 9 included an indicator of pregnancy-specific anxiety (7 with significant results). CONCLUSION: Overall research outcomes were equivocal. Across studies on symptoms of depression and anxiety, findings related to the potential effect on infant temperament were mixed. Nonetheless, support for the role of prenatal psychological factors in the development of infant temperament emerged in a subset of population-based studies, including research to target the effects of pregnancy-specific anxiety. Future research is needed with greater consistency across studies with respect to methods (e.g., timing and assessment tools). Specific recommendations for nurses and providers include more routine screening and psychoeducation for expectant mothers about prenatal symptoms of depression and anxiety and about pregnancy-specific anxiety in particular.

Urban and rural utilization of evidence-based practices for substance use and mental health disorders.

PURPOSE: The purpose of the investigation was to examine variations in evidence-based practice (EBP) utilization between rural and urban mental health and substance abuse prevention provider agencies in Washington State. METHODS: We conducted a secondary analysis of the 2007 EBP Survey, which was administered to 250 of Washington State Department of Social and Health Services' contracted mental health and substance abuse treatment agencies. The survey solicited input from solo and group practices across the state on EBP implementation, successes, and challenges. FINDINGS: Most mental health and substance abuse treatment agencies used more than 1 EBP, although rural substance abuse agencies were less likely to do so than urban agencies. Rural substance abuse agencies were more likely to be solo than group practices. Urban agencies reporting significantly more collaboration with universities for EBP training, although training by internal staff was the most commonly reported training mechanism regardless of agency focus or location. Over half of agencies reported conducting no systematic assessment of EBPs, and of those who did report systematic assessment, most used outcome monitoring more than program evaluation or benchmarking. Urban and rural mental health and substance abuse prevention providers reported shortages of appropriately trained workforce and financing issues available to pay for EBPs as the greatest barriers to utilization. CONCLUSIONS: Challenges to EBP utilization and fidelity should be monitored as EBPs contribute to the delivery of high-quality care. Collaborations between universities and rural agencies may support an agency's abilities to adopt EBPs, train staff, and systematically assess impact.

The future of the population-focused, public health clinical nurse specialist.

This article addresses the need for continued certification of community and public health nurses at the advanced practice registered nurse level, and explores curricular avenues and policy recommendations with regard to certification and education of these nurses. The transformation of health care and burgeoning access to information has changed what the public expects and needs from health professionals. Nursing roles have expanded and transformed, in turn requiring that the education, licensure, certification, and accreditation of the professional likewise change.

Billings' methamphetamine epidemic. Nursing leaders frame a public health and environmental health problem.

Methamphetamine use in rural communities is at epidemic levels and constitutes a public health crisis in many parts our nation. This synthetically-derived drug is commonly manufactured in illicit laboratories in homes and has harmful consequences for both people and the environment. Three RWJ nurse Fellows collaborated on community health efforts to heighten Montana citizens' awareness of the methamphetamine problem and to leverage additional resources for the fight against drugs. The Fellows efforts, combined with the ongoing efforts of other Montana politicians and leaders, have recently led to a significant infusion of federal drug enforcement and treatment funds into the state.

Squeezing the turnip. Equitable distribution of funding to provide maternal and child health services in rural America.

Public health services in local communities are a vital key to maintain and promote the health of the public. Local public health programs provide services to the entire population including the maternal and child health population. Funding to support public health services is very limited; few of the population-based services that include assessment, investigation of contagion, and education are billable by government or private insurers. Federal funding in the form of the Maternal and Child Health Block Grant is an important resource. Title V of the Social Security Act requires that states equitably distribute funding to provide services to the maternal child health population. State and local leaders must work together to establish and implement allocation methods that are sensitive to existing and developing needs.