Building a Practice-Focused Academic-Practice Partnership.

A practice-focused academic-practice partnership merging the strengths and resources of 2 faith-based community organizations built evidence-based practice, nursing research, and innovative nursing programs. The unique partnership emphasizing quality care and patient outcomes resulted in hospital-acquired infection reduction, interventional research reducing readmissions, clinical redesign, increased percentage of bachelor's degree-prepared nurses, and dissemination through publication and presentation. Key elements to partnership success were shared mission and vision, program oversight, strong contract, and annual plans with specific measurable outcomes.

Mock Institutional Review Board: Promoting Analytical and Reasoning Skills in Research Ethics.

Although it is critical that nurses possess ethical reasoning skills for research, there is limited information on effective strategies to develop these skills in graduate health care students. A research study analyzing educational interventions including the effect of online human subjects training followed by a mock institutional review board simulation demonstrated that knowledge acquisition is not enough to acquire the ethical reasoning skills needed to implement health care research. Situational context is also needed to envision the application of ethical principles.

THE EFFECT OF A CULTURALLY TAILORED SUBSTANCE ABUSE PREVENTION INTERVENTION WITH PLAINS INDIAN ADOLESCENTS.

PURPOSE: To examine the effects of incorporating tribal specific cultural beliefs into a tailored substance abuse prevention intervention for at risk rural Oklahoma Native American Indian (NAI) Plains adolescents. RESEARCH DESIGN: The 10 hour Native American Talking Circle Intervention, a school-based, group substance abuse prevention program, was implemented over a 8.5 week period and evaluated using a one group, pretest-posttest design. Measurements were from the Native Self-Reliance Questionnaire and the Substance Problems Scale from Global Appraisal of Individual Needs-Quick (GAIN-Q). FINDINGS: One-tailed, paired sample t-tests demonstrated significant increase in self-reliance, from 86.227 to 92.204 (t (43) = -2.580, p = .007) and a decrease in substance abuse/use, from 2.265 to 1.265 (t (33) = 1.844, p = .007). CONCLUSIONS: The Native Talking Circle Intervention based on tribal-specific values and beliefs was shown to be effective with substance abuse/use at-risk NAI Plains tribal adolescents.

Promotores and the Chronic Care Model: an organizational assessment.

Although promising research is developing related to promotores and the Chronic Care Model (CCM), studies of the effectiveness of the integration of these two system innovations in addressing health disparities are limited. This article reports on an organizational assessment and analysis of promotores working in a system of federally-sponsored community health clinics along the United States-Mexico border where the CCM has been operationalized. The work of promotores was found to be largely invisible within the CCM. This highlights the need for further investigation if the potential of these combined system innovations to address health disparities among Hispanics is to be realized.

Correlations between spirituality and health-promoting behaviors among sheltered homeless women.

This study examined the relationship between spirituality and health-promoting behaviors in a convenience sample of 90 sheltered homeless women using the Health Promotion Lifestyle Profile II, the Spiritual Well-Being Scale, and a demographic questionnaire. A moderate positive correlation was found between spiritual well-being and overall health promoting lifestyle (r = .426). Moderate to strong positive correlations were found between the Spiritual Well-Being Scale and the Health Promotion Lifestyle Profile II dimension subscales (physical activity, nutrition, spiritual growth, interpersonal relations, and stress management). The results support the importance of spirituality in relation to health-promoting behaviors among sheltered homeless women.

Continuing the cultural competency journey through exploration of knowledge, attitudes, and skills with advanced practice psychiatric nursing students: an exemplar.

Numerous training and education programs have evolved to address culturally competent health care delivery. This article describes an exemplar educational approach used to teach cultural competency to beginning graduate psychiatric mental health nursing students. Using interactive strategies delivered within the 4 phases of the curriculum, the approach has been shown to facilitate students' ongoing journey to cultural competence. Building on baccalaureate nursing competencies, the course addresses attitudes, knowledge, skills, and cultural humility to strengthen cultural self-assessment, cross-cultural clinical practice expertise, and the use of culturally appropriate research for graduate students.

Academic faculty qualifications for community/public health nursing: an Association of Community Health Nursing Educators position paper.

The Association of Community Health Nursing Educators (ACHNE) has developed a number of documents designed to delineate the scope and function of community/public health nursing (C/PHN) educators, researchers, and practitioners. Consistent with the mission of ACHNE, this position paper entitled Academic Faculty Qualifications for Community/Public Health Nursing has been developed by the Faculty Qualifications Task Force. The shortage of qualified nursing faculty has been well documented. In particular, this shortage has increased the difficulty in having sufficient numbers of faculty who are educationally and experientially qualified to teach in the C/PHN specialty. ACHNE is addressing this concern by setting forth preferred qualifications for faculty to teach C/PHN at both the graduate and undergraduate level. While we recognize that the current faculty shortage may require schools to use faculty to teach in areas in which they do not have appropriate formal preparation, the paper outlines best practices for teaching C/PHN, a goal we urge all schools of nursing to work toward. Task Force members developed an earlier draft of the document in fall 2008, and input was solicited and received from ACHNE members and considered in the final document, which was approved by the ACHNE Executive Board in July 2009.

Risk factors for excessive or inadequate gestational weight gain among Hispanic women in a U.S.-Mexico border state.

OBJECTIVE: To identify risk factors for excessive or inadequate gestational weight gain and associated morbidities among Hispanic women in a U.S.-Mexico border state. DESIGN: Case-control design. SETTING: New Mexico. PARTICIPANTS: Hispanic women responding to the New Mexico Pregnancy Risk Assessment Monitoring System 2000 to 2003; 1,597 women in final excessive versus adequate gestational weight gain analyses and 1,351 in final inadequate versus adequate gestational weight gain analyses. METHODS: Information from birth certificates and Pregnancy Risk Assessment Monitoring System questionnaires were use in logistic regression analyses to identify risk factors and associated events. RESULTS: Prevalence of excessive gestational weight gain was 35.7%, while inadequate gestational weight gain was 30.4%. Among factors associated with increased risk of excessive gestational weight gain were overweight (odds ratio [OR]=2.87, 95% confidence interval [CI]=2.11, 3.90) or obese status (OR=1.82, 95% CI=1.38, 2.39), whereas residing in a U.S.-Mexico border county reduced such risk (OR=0.75, 95% CI=0.59, 0.97). Among risk factors for inadequate gestational weight gain were gestational diabetes (OR=1.58, 95% CI=1.05, 2.37) and inadequate prenatal care (OR=2.17, 95% CI=1.56, 3.02). After adjusting for confounders, inadequate gestational weight gain increased risk of low birth weight (OR=l.92, 95% CI=1.11, 3.29), while excessive gestational weight gain reduced this risk (OR=0.29, 95% CI=0.12, 0.68) but increased risk of macrosomia (OR=2.07, 95% CI=1.32, 3.25). CONCLUSION: Prepregnant overweight and obese status were among factors associated with excessive gestational weight gain among Hispanic women, whereas inadequate prenatal care was among factors associated with increased risk of inadequate gestational weight gain.

Development of a dynamic model to guide health disparities research.

Various populations experience health disparities related to risk factors such as gender, race or ethnicity, educational level, income level, and geographic location. These populations often experience barriers to access and utilization of services, which can lead to adverse health outcomes. Health promotion interventions developed within the context of communities represent resources that may offer protection to these populations. The purpose of this article is to describe the evolution of a conceptual model for the study of health disparities. The model, based on a review of literature, was developed to guide 19 pilot studies funded by the Texas-New Mexico P20 Southwest Partnership Center for Nursing Research on Health Disparities. Reflection on these studies, their respective methodologies, and findings resulted in a revised model to guide further studies of communities experiencing health disparities.

Using objective structured clinical examinations to meet clinical competence evaluation challenges with distance education students.

PURPOSE: This study aims to describe the use of modified objective structured clinical examinations (OSCEs) developed to address the identified educational need for formative advanced practice psychiatric mental health (PMH) student assessments and focused learning experiences within a modified nursing distance education program that serves advanced practice nurse PMH students from rural/underserved areas. CONCLUSION: OSCEs represent a practical solution to the challenges of clinical competency evaluation in psychiatric nursing distance education programs. PRACTICE IMPLICATIONS: OSCEs add a supportive evaluation layer to the precepted experience. This increases the availability of PMH nurse practitioner/clinical nurse specialist distance education programs focused on improving advanced PMH nursing services in rural and underserved areas.

Applying the concept of positive deviance to public health data: a tool for reducing health disparities.

The concept of positive deviance (PD), which highlights uncommon practices that reduce risk in low-resource communities, has been effective in community mobilization and programming to improve health outcomes. We present a protocol for extending the concept to analysis of existing public health data. The protocol includes assessing whether PD fits the situation, identifying positive deviants, and identifying behaviors associated with positive deviants' healthy outcomes. Analyzing existing datasets from a PD perspective may aid public health nurses in efforts to reduce health disparities. The effectiveness of our protocol will be clarified in future research.

Outcomes of ADN-BSN partnerships to increase baccalaureate prepared nurses.

The limited supply of BSN nurses hinders efforts to increase patient care quality and address health disparities. In largely rural and economically disadvantaged areas, associate degree prepared nurses provide the majority of nursing services. To address a statewide need, a BSN Program and 3 ADN Programs formed a partnership to take BSN education to rural and medically underserved areas. This article describes the program planning, implementation, and evaluation using an adapted assessment framework with partnership principles as its foundation. Interactive television, internet education components, local clinical experiences, and distant nursing faculty liaisons were used. The nursing course sequence was completed by 101 of 102 students. Hall's Professionalism Scale, the California Critical Thinking Disposition Inventory, and the California Critical Thinking Skills Test measured the increases found in professional socialization and critical thinking. Use of the adapted theoretical framework represented a strategic approach to developing a distance delivered nursing education program.

Licensing web-based nursing programs, courses, and course materials.

With the advent of the digital information age, schools of nursing are developing and using web-based programs, courses, and course materials to meet students' needs for access and high-quality learning experiences. In an attempt to maximize scant resources, including faculty, many schools are seeking grant funding, joining consortia, or forming partnerships that require sharing of web-based course materials. Entering such collaborative arrangements usually requires licensing agreements to transfer intellectual capital. This article explains licensing and the related concepts of intellectual property, copyright, and technology transfer. It also identifies the advantages and disadvantages of licensing and describes a licensing process.

The impact of active learning on nursing students' clinical success.

Active, cooperative learning is a method to teach the critical thinking skills necessary for the transfer and use of classroom-acquired knowledge in the clinical setting. Yet many nursing educators continue to use teacher-centered educational approaches while identifying an array of barriers for the voiced preference for student-centered education. Using holistic, active cooperative learning strategies (faculty role modeling, student interactive and group learning, and group testing) within a didactic class, the authors found differences in the average clinical grade (87.03) when compared to the average clinical grade for students who had been taught using a lecture approach (84.19).

Lessons learned: research with rural Mexican-American women.

The authors share lessons learned from 5 community-based research studies involving rural Mexican-American women. The 10 lessons revolved around compensation, confidentiality, recruitment, crossing paths, mailings, locating people, participation/attendance, translation, children, and closure. Despite their clinical knowledge and previous experiences in service with this population, researchers found recruiting and retaining participants and data collection far more challenging than expected. This article is significant as it illustrates the extensive time, expense, and effort required to conduct research with a rural population experiencing health disparities. Recommendations are provided to assist in planning and designing community-based and culturally sensitive research that has realistic time and budget allowances.