Thai novice nurses' lived experiences and perspectives of breastfeeding and human milk in the Neonatal Intensive Care Unit (NICU).

BACKGROUND: Breastfeeding and human milk have well-documented health benefits for newborn infants, particularly those who are sick. However, breastfeeding rates and human milk feeding among infants in neonatal intensive units (NICU) in Thailand are still low; thus, breastfeeding promotion and support are required for Thai mothers of premature infants. Newly graduated nurses can play a critical role within the healthcare support system and can have a significant impact on improving breastfeeding practices in the NICU. The objective of this study was to investigate the lived experiences and perspectives of Thai novice nurses on supporting breastfeeding and human milk feeding in the NICU. METHODS: The study was conducted between March 2021 and May 2022 at three medical centers in the central region of Thailand. This study employed a descriptive phenomenological approach to explore Thai novice nurses' experiences and perspectives on breastfeeding. Purposive sampling was used to invite Thai novice nurses who have work experience in providing breastfeeding support to NICU mothers and their infants to participate in online interviews using a video conference platform (Zoom). Semi-structured questions were used to interview study participants in their native language. Data were analyzed using Colaizzi's method of data analysis to identify emergent themes. Member checks, peer debriefing, and self-reflection were applied to ensure the validity and trustworthiness of the study results. Back-translation was also used as a quality and accuracy assurance. RESULTS: A total of thirteen novice nurses agreed to participate in the study. All were female, and their ages ranged from 21 to 24 years old at the time of the interview. The researchers identified five major themes related to the overall study objectives and research questions. They are: positive attitude toward breastfeeding and human milk, facing breastfeeding challenges at work, self-confidence rooted in experience, professional skill needs, and requiring further support. CONCLUSIONS: Our results suggest that breastfeeding education plays a vital role in encouraging new nurses to provide breastfeeding support to mothers of preterm infants. Establishing breastfeeding support training and innovative learning strategies can be crucial in developing appropriate breastfeeding practice guidelines and policies to support Thai breastfeeding mothers in the NICU.

NYS Nonprofit Hospital Assessment and Response to Environmental Pollution as Community Health Need: Prevalence in Community Benefit Practices.

CONTEXT: Given the impact of environmental pollution on health and health inequity, there may be substantial value in integrating assessment and response to pollution into nonprofit hospital community benefit processes. Such hospital engagement has not yet been studied. OBJECTIVES: We take a preliminary step of inquiry in investigating if nonprofit hospitals in New York State (NYS) assess, identify, or respond to environmental pollution as part of community benefit processes. DESIGN: This study is of retrospective, observational design. Data were abstracted from community health needs reports (2015-2017), associated implementation plans, and related IRS (Internal Revenue Service) filings from a randomly geographically stratified selection of NYS nonprofit hospitals. PARTICIPANTS: The sample includes 53 hospitals from 23 counties. The sampling frame consists of NYS nonspecialty private nonprofit hospitals. MAIN OUTCOME MEASURES: Dichotomous findings for the following: (1) engagement of environmental pollution in the process of assessment of community health needs; (2) environmental pollution concern identified as a priority community health need; (3) strategic planning present to address pollution identified as community health need; and (4) action taken on same. RESULTS: We found that 60.5% (95% confidence interval [CI], 0.46-0.74) of hospitals evidenced some form of assessment of environmental pollution and 18.9% (95% CI, 0.09-0.32) identified pollution as a priority community health need. However, no hospital went on to take independent or collaborative planning or action to address pollution. In additional analysis, we found that social justice in hospital mission was a positive predictor of assessment of environmental pollution. CONCLUSIONS: For NYS hospitals, we found a substantial presence of assessment and identification of pollution as a community health concern. Our finding of the absence of response to environmental pollution represents a gap in community benefit implementation. This indicates a yet untaken opportunity to address racial and economic environmental health injustices and to improve population health.

A Mixed Methods Study of Hearing Loss, Communication, and Social Engagement in a Group Care Setting for Older Adults.

Purpose: The purpose of this study is to characterize the communication needs of older adults in group care environments and understand the factors that foster engaged communication. Method: This mixed methods study provides an in-depth analysis of communication and engagement for older adults at two Program for All-inclusive Care for the Elderly (PACE) sites. Seventy-two PACE participants (M age = 74 years) completed a hearing test, cognitive screener (MOST™), the Institute of Medicine (IOM) Measures of Social and Behavioral Determinants of Health Questionnaire, and the UCLA Loneliness Scale. Using maximum variation sampling based on hearing status and UCLA Loneliness scores, 19 participants were invited to do (and 11 participants completed) one-on-one semi-structured interviews. In addition, 35 staff members participated in 5 focus groups. Field observations were interspersed throughout the data collection period. Results: Results suggest that communication challenges such as hearing loss, cognitive decline, and social isolation are highly prevalent in this convenience sample. Sixty-seven percent have at least a mild hearing loss in the better hearing ear. Eighty-two percent scored in the "very" or "most isolated" range of the IOM Measures of Social and Behavioral Determinants of Health questionnaire. The mean score on the MOST™ cognitive screener was 17.6, which is below the dementia screening cutoff score of 18 points. A thematic analysis of the qualitative data suggests that the PACE programs support socialization and engagement. A conceptual framework was developed by integrating quantitative and qualitative findings to recognize what contributes to meaningful interactions or engaged communication. Conclusion: Identifying communication challenges can enhance the benefits individuals can experience at care facilities and lessen the burden of the staff members trying to provide safe and effective care. In order to maximize the potential benefit of attending group-based day centers, the communication challenges and motivations of older adults need to be addressed.

Social Influences on Perceptions of Sense of Control and Attributed Dignity Among Older People Managing Multiple Chronic Conditions.

PURPOSE: The aim of this study was to explore associations between social support, sense of control, and attributed dignity in persons aged 65 years and older who self-manage multiple chronic conditions while living in the community. DESIGN: A descriptive, nonexperimental, correlational design was used in this study. METHODS: Eighty-nine participants completed telephone surveys that measured social support, sense of control and attributed dignity. Regression analysis was used to identify associations. RESULTS: Participants were independent in seven of the eight instrumental activities of daily living, with participants having an average of 11 (±4) chronic conditions. Significant positive relationships between social support, perceived sense of control, and attributed dignity were identified. CONCLUSIONS: Positive social support is strongly associated with perceived sense of control and attributed dignity. CLINICAL RELEVANCE: Healthcare professionals, especially rehabilitation nurses, can assess social support and offer ways to improve social support, thus enhancing sense of control and attributed dignity. These concepts enhance older individuals' ability to manage multiple chronic conditions.

Peer-led family-centred problem management plus for immigrants (PMP-I) for mental health promotion among immigrants in USA: protocol for a pilot, randomised controlled feasibility trial.

INTRODUCTION: Research is needed to investigate preventive strategies to reduce mental health burden and assess effective implementation among immigrants. Problem management plus (PMP) is a low-intensity multicomponent psychological intervention developed by the World Health Organization (WHO) that trained laypeople can deliver. PMP has been adapted as a prevention intervention and developed as PMP for immigrants (PMP-I), including psychoeducation, problem-solving, behavioural activations and mind-body exercise, to address immigrants' multiple stressors. This pilot trial aims to assess the feasibility and acceptability of PMP-I and provide a preliminary estimate of the difference between PMP-I versus community support services pamphlets on the primary outcomes of interest (stress, anxiety and depressive symptoms) to inform the design of a large-scale intervention. METHODS AND ANALYSIS: The feasibility and acceptability of PMP-I will be assessed by measuring recruitment, session attendance, retention rates, programme acceptability and the fidelity of intervention delivery. This pilot trial will test preliminary effects of PMP-I vs community support services pamphlets in a randomised controlled trial (N=232 participants from 116 families (2 members/family); 58 families randomised to condition intervention or control) on stress, anxiety and depressive symptoms (primary outcomes), chronic physiological stress assessed in hair cortisol (secondary outcomes), and coping, family conflict resolution, and social networking (targets), with assessment at baseline, postintervention and 3-month postintervention. Eligibility criteria for the primary study participants include Bhutanese ≥18 years resettled in Massachusetts with a score of ≤14 on the Patient Health Questionnaire-9. All family members will be invited to participate in the family-based intervention (one session/week for 5 weeks). Multilevel modelling will compare the longitudinal change in outcomes for each treatment arm. ETHICS AND DISSEMINATION: The Institutional Review Board of the University of Massachusetts Amherst approved this study (Protocol: 1837). Written informed consent will be obtained from all participants. The study results will be used to inform the design of a large-scale intervention and will be disseminated in peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER: NCT04453709.

Usability Experience of a Personal Sleep Monitoring Device to Self-manage Sleep Among Persons 65 Years or Older With Self-reported Sleep Disturbances.

Increasingly, persons with self-reported health symptoms are using mobile health technologies to better understand, validate, and manage their symptoms. These off-the-shelf devices primarily utilize actigraphy to estimate sleep and activity. The purpose of this study was to describe qualitatively the experience of using a personal sleep monitoring device for sleep self-management in adults 65 years or older with self-reported sleep disturbances. This study followed a hybrid qualitative design using deductive and emergent coding derived from open-ended interviews (n = 25) after a period of 4 weeks using a wearable personal sleep monitoring device. Results expanded existing theoretical models on usability with the theme of personal meaning in the interaction between health and self-monitoring technology that were associated with age and technology use, privacy, and capability. Future studies for sleep health self-management and personally tailored interventions using personal sleep monitoring devices should continue to collect qualitative information in extending the understanding of user experience across different symptom clusters, such as sleep disturbances, that manifest more commonly in older age populations. This research is important for application in the use of mobile health technologies for nursing led health self-management interventions.

Examining a Fatigue Management Model in Older Individuals.

PURPOSE: The aim of this study was to examine a fatigue model for older individuals based on the theory of unpleasant symptoms. RESEARCH DESIGN: The research design used was a secondary data analysis of the "Patient-Reported Outcomes Measurement Information System Profiles-Health Utilities Index" data set. METHODS: Multiple regression analysis and path analyses were used to examine hypothesized model paths. RESULTS: A number of comorbidities, pain, sleep, depression, anxiety, education, and sensory impairment were significant predictors of fatigue. Higher fatigue scores predicted lower physical, social, and cognitive performances, as well as worse perceived health and quality of life (QOL). In addition, the identified fatigue outcomes mediated the relationship between fatigue and QOL. CONCLUSIONS: Future research should be directed toward exploring other risk factors of fatigue and examining feedback loops depicted in the theory of unpleasant symptoms. CLINICAL RELEVANCE TO THE PRACTICE OF REHABILITATION NURSING: Rehabilitation nurses should closely monitor and manage the identified fatigue-influencing factors to improve older individuals' performance, perceived health, and QOL.

Social relationship influence on self-care and health among older people living with long term conditions: A mixed-methods study.

BACKGROUND: Social relationships influence health, yet less is known on how social relationships influence self-care among older people living with multiple long-term conditions. OBJECTIVES: The purpose of this study was to determine how social networks influence therapeutic self-care behaviours and health among community dwelling older people living with multiple long-term conditions. DESIGN: Explanatory sequential mixed-methods. SETTING/SAMPLE: Community dwelling older people living in the Northeast United States. METHODS: A cross-sectional sample of eighty-nine people aged sixty-five and older participated in telephone surveys. A nested sample of twelve participants completed a follow-up open-ended interview. Descriptive statistics, bivariate correlations and regression statistics were used to examine the associations between social network features and functions with the dependent variables of therapeutic self-care behaviours and health. Qualities that emphasised the contexts of the relationships were integrated in the data analysis. RESULTS: The strength of the social network and level of social support influenced the outcomes of therapeutic self-care and mental health. Thematic analysis expanded this explanation of self-care in relation to social network size, psycho-social support, activation of support, interaction frequency and type. CONCLUSION: In supporting older people living with multiple long-term conditions, this nursing research offers new ways to understand close social relationships influence on self-care in developing systems of care at the community level. IMPLICATIONS FOR PRACTICE: Designing care systems that include small trusted formal and informal caregivers that integrate social network members could improve health outcomes and improve access to supportive resources.

Dignity of the patient--family unit: further understanding in hospice palliative care.

OBJECTIVES: This study aimed to explore the construct of dignity of the patient-family dyad in hospice palliative care, as well as its influencing factors from the perspective of hospice palliative care staff. METHODS: A qualitative descriptive study was conducted with 34 staff members from a residential hospice in Amherst, USA, and an inpatient palliative care unit in Winnipeg, Canada, between September 2013 and December 2016. Data were collected through semistructured interviews and were analysed using the thematic analysis approach. RESULTS: Findings suggested that staff members viewed dignity as something that is reciprocally supported within the patient-family unit. Themes including respect, comfort, privacy, being informed and quality family time were common in the conceptualisation of dignity in patients and families; themes of being human and being self, autonomy and living with dignity were uniquely used to conceptualise patient dignity. Themes solely constituting family dignity included being included in care, being capable and being treated fairly. Cultural considerations, environmental factors, teamwork and patient/family-staff relationship were the factors identified by staff members that affected dignity in hospice palliative care. CONCLUSION: Findings of this study provide insights into the development of strategies to support the dignity of the patient-family unit in hospice palliative care.

Mental health promotion among resettled Bhutanese adults in Massachusetts: Results of a peer-led family-centred Social and Emotional Well-being (SEW) intervention study.

Family-centred interventions addressing sociocultural and emotional stressors promise to prevent mental health problems among refugees in the United States. Peer-led strategies are highly valued, as they engage communities and promote the sustainability of interventions. We assessed the effects of a peer-led family-centred Social and Emotional Well-being (SEW) intervention on preventive (coping, social networking and conflict resolution) and mental health outcomes (stress, anxiety and depression) among resettled Bhutanese adults in Massachusetts. We conducted a SEW intervention with a pre-intervention versus post-intervention (7-day) and follow-up (3-month) evaluation among 103 adults (50 families). The SEW is a culturally tailored 5-weekly session program that included health education, problem-solving and mind-body exercises to increase knowledge and skills regarding stress management and conflict resolution. We measured anxiety and depression using the Hopkins Symptom Checklist-25 and stress using Cohen Perceived Stress scales. Health-promoting behaviours were measured using validated scales. We used paired t-tests for continuous and McNemar tests for categorical variables. Mean scores significantly decreased from pre-intervention to post-intervention and follow-up for stress by 15% and 13.9%, anxiety by 20.9% and 25.1% and depression by 18.7% and 20.4% (all p's < 0.01). Mean scores increased from pre-intervention to post-intervention and follow-up for coping by 10% and 17.2%, and for community networking by 28% and 36.8% (all p's < 0.01). Generalised estimating equations showed a significant reduction in stress, anxiety, depression and improved coping, self-efficacy, family and community networking scored from baseline to follow-ups (all p's < 0.01). Our peer-led family-centred SEW intervention was associated with improved preventive and mental health outcomes among Bhutanese adults.

Sleep, Mild Cognitive Impairment, and Interventions for Sleep Improvement: An Integrative Review.

Sleep disturbance in mild cognitive impairment (MCI) is associated with progression to Alzheimer's disease (AD), more severe AD symptoms, and worse health outcomes. The aim of this review was to examine the relationship between sleep and MCI, and the effectiveness of sleep improvement interventions for older adults with MCI or AD. An integrative review was conducted using four databases, and findings were analyzed using an iterative process. Findings from 24 studies showed that alterations in sleep increased the risk of MCI and that the sleep quality of individuals with MCI or AD was poorer than healthy controls. Changes in brain anatomy were also observed in healthy older adults with sleep disturbances. Examined interventions were shown to be effective in improving sleep. Screening for sleep disturbances in individuals with MCI/AD is crucial to mitigate neurodegenerative or neurobehavioral risks in this population.

Social and Emotional Wellbeing (SEW) Intervention for Mental Health Promotion Among Resettled Bhutanese Adults in Massachusetts.

Preventative behavioral interventions aimed at reducing mental problems among refugees are limited. We assessed the effect of a Social and Emotional Wellbeing (SEW) intervention on health-promoting behaviors (coping, social-networking, and conflict-resolution) and health-outcomes (stress, anxiety, and depression) among resettled Bhutanese adults in Western Massachusetts. The study was a community-based SEW intervention with pre-posttest evaluation among 44 Bhutanese adults in Western Massachusetts. The SEW is a culturally tailored 5-week, once-weekly health-education, problem solving, and mind-body exercise program to promote stress management skills. We used validated scales to measure outcomes. Mean scores of mental problems decreased by 5.9 for depression, 9.0 for anxiety, and 5.0 for stress post-intervention (p < 0.01). Mean scores increased by 27.3 for coping, 10.6 for social support, and 20.4 for conflict-resolution. Mean social-network scores increased by 4.6 for family, 4.7 for friends, and 1.8 for community networks (p < 0.01). Our Bhutanese participants reported improvement in their mental health after attending SEW intervention.

Use of a Personal Sleep Self-Monitoring Device for Sleep Self-Management: A Feasibility Study.

The purpose of the current study was to establish feasibility of personal sleep monitoring devices (PSMDs) as an intervention for sleep self-management in older adults. This study followed a mixed-methods experimental design based on the World Health Organization's International Classification of Functioning, Disability, and Health, and the proposed conceptual model of symptom management in a social context. Results showed an acceptable recruitment and retention rate of participants, and acceptability of PSMDs by users. Participants were able to meaningfully interpret PSMD data as evidenced by the numeracy evaluation scores, initiate sleep goals, and share their sleep data and goals with friends or relatives. Findings support extending this research protocol to a larger sample. Future studies for sleep health self-management and personally tailored interventions using personal sleep monitoring are recommended. [Journal of Gerontological Nursing, 47(1), 28-34.].

Chronic Illness and Fatigue in Older Individuals: A Systematic Review.

BACKGROUND: Fatigue is a symptom experienced by 40%-74% of older individuals in the United States. Despite its significance, clinicians face challenges helping individuals to manage or reduce fatigue levels. Some management issues are attributable to the ambiguity around the risk factors, consequences, and the effect of fatigue management strategies. METHODS: A literature review was conducted using four databases to identify themes in relation to risk factors, consequences, and management strategies from research studies about fatigue in older individuals with chronic diseases. RESULTS: Findings on fatigue risk factors, such as age, body mass index, and marital status, were contradictory. There was a positive association between fatigue and comorbidities, depression, and anxiety and a negative relationship between fatigue and physical activity, sleep, educational status, and socioeconomic status. Fatigue was perceived as a state of "feebleness" and negatively impacted individuals' quality of life. Consequences of fatigue included tiredness, sleepiness, depression, anxiety, worse sense of purpose in life, poor self-care, and an increased ß-amyloid load. Predictors of worse fatigue consequences included functional health, symptom burden, subjective health, and self-acceptance. Fatigue management strategies included physical activity, rest, sleep, maintaining normal hemoglobin levels, and acetyl-l-carnitine supplementation. CONCLUSION: This systematic review is of value to older individuals with chronic illnesses, researchers, and clinicians who strive to improve the quality of life of individuals experiencing fatigue. To prevent undesirable consequences of fatigue, older individuals should be screened for the discussed modifiable risk factors of fatigue. The inconsistencies in the studies reviewed can guide researchers to potential research areas that require further inquiry and exploration to ground future practice on best scientific evidence.

Coping strategies and stress among resettled Bhutanese adults in Massachusetts.

Stress associated with attempts to integrate into a new culture is directly linked to mental health outcomes among refugees. However, there is a paucity of literature on how refugees cope to reduce their stress. This study assessed the association between coping strategies and perceived stress among resettled Bhutanese adults in Western Massachusetts. A cross-sectional survey was conducted among 225 Bhutanese (men: 113, women: 112) refugees aged 20-65 years residing in Massachusetts. Coping was measured with the 32-item Tobin Coping-Strategies Inventory-Short Form (CSI-SF). The 32-item CSI-SF includes 8 subscales: problem-solving, cognitive-structuring, express-emotions, social-contact, problem-avoidance, wishful thinking, self-criticism, and social-withdrawal, each with 4 items. Four composite constructs were created from subscales, namely, problem-focused engagement (problem solving + cognitive structuring), emotion-focused engagement (express emotions + social contact), problem-focused disengagement (problem avoidance + wishful thinking), and emotion-focused disengagement (self-criticism + social withdrawal). Perceived stress was measured with the 10-item Cohen Perceived Stress Scale. Associations of coping scores with perceived stress score (PSS) were assessed using multiple linear-regression analyses adjusting for sociodemographic, and lifestyle factors. The coping scores of 4 subscales were inversely associated with PSS including problem solving (ß = -0.430, p ≤ .0001), cognitive structuring (ß = -0.416, p = .0002), express emotions (ß = -0.292, p = .004), and social contact (ß = -0.448, p ≤ .0001). Two composite constructs of subscales, namely, problem-focused (ß = -0.236, p ≤ .0001) and emotion-focused (ß = -0.199, p = .0003) engagement coping strategies were inversely associated with PSS. Greater use of problem- or emotion-focused engagement coping strategies was associated with reduced PSS among Bhutanese, suggesting that problem-focused or emotion-focused stress management interventions hold promise for stress reduction among resettled Bhutanese. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Improving Mental Health in Refugee Populations: A Review of Intervention Studies Conducted in the United States.

Mental health is one of the most pervasive health concerns in the refugee population due to the combined effects of traumatic experiences prior to migration and post-migration stressors related to resettlement. The objectives of this systematic search were to synthesize evidence on the effectiveness and identify gaps of mental health interventions on mental health outcomes for refugees resettled in the United States. This review search identified a combination of quasi-experimental (7 studies) and qualitative research studies (5 studies). Twelve papers, published between 2003-2017, evaluating twelve different interventions, were selected for review. Studies were conducted in a variety of refugee populations: Africans (8), Southeast Asians (2), Bhutanese (1), and multicultural (1). Interventions included groups/workshops (10) and individual counseling (2). The results from the mental health interventions showed increases in health confidence, health seeking behaviors, consistency with treatment course, English proficiency, quality of life, and level of enculturation. Results also showed decreases in depression and psychological distress. Also identified from this review were different methods for interventions including linguistic and ethnically-matched facilitators versus non-matched facilitators, as well as group interventions versus non-group interventions. These differences were identified in the review and discovered to be areas for further research as these items were not often addressed in the literature.

Older adults' experiences with a tablet-based self-management intervention for diabetes mellitus type II: A qualitative study.

Technological interventions to support self-management can potentially help older adults manage their health, live active lives, and maintain their independence. The objective of this study was to assess individuals' experiences and perceptions of using a tablet-based application for 30 days as a component of routine diabetes self-management care in older adults with type 2 diabetes mellitus (T2DM) in the context of daily living. A qualitative research design using semi-structured interviews was used. The participants found the tablet-based application to be a beneficial and valuable component of their routine self-management activities. Five themes emerged from the interviews, namely self-dependence, awareness, positive impact on attitude and behavior, support, and balance. Findings from the individual interviews indicate that technological applications have a unique potential to support the foundations for attitude and behavioral changes toward self-management behaviors and activities, thus improving clinical outcomes.

Cancer Pain Social Processes and Pain Management in Home Hospice Care.

BACKGROUND: The high incidence of pain associated with end-stage cancers indicates the need for a new approach to understanding how and why patients, caregivers, and clinicians make pain management choices. AIMS: To provide pilot data and preliminary categories for developing a middle-range nursing theory and framework through which to scrutinize and identify problematic processes involved in management of poorly controlled pain for home hospice patients, caregivers, and nurses, the "caring triad." DESIGN: A qualitative pilot study using constructivist grounded theory methodology to answer the question, "In the context of hospice, what are the social processes occurring for and between each member of the hospice caring triad and how can these processes be categorized?" SETTINGS: Home hospice care. PARTICIPANTS/SUBJECTS: Hospice patients experiencing cancer pain, family caregivers, hospice nurses. METHODS: From a sample of triads including hospice patients, caregivers and nurses, data were collected at observational visits, individual interviews, and a focus group over the course of each triad's study involvement. We used recursive coding processes to interpret data. RESULTS: Three preliminary categories of social processes were identified: Pain Meaning, Working Toward Comfort, and Bridging Pain; and six subcategories: perceiving pain and discomfort, knowing what to do, planning activities, negotiating a pain plan, talking about pain, and being together in pain. CONCLUSIONS: As illustrated in the caring triad cases presented, this study moved the management approach of pain from a dichotomous realm of nurse-patient, to the more naturalistic realm for home hospice of nurse-patient-caregiver. In analyzing social processes within and across triad members, we identified categories of impact to target assessment, intervention, and education to improve pain outcomes.

The Use of Technology to Support Precision Health in Nursing Science.

PURPOSE: This article outlines how current nursing research can utilize technology to advance symptom and self-management science for precision health and provides a roadmap for the development and use of technologies designed for this purpose. APPROACH: At the 2018 annual conference of the National Institute of Nursing Research (NINR) Research Centers, nursing and interdisciplinary scientists discussed the use of technology to support precision health in nursing research projects and programs of study. Key themes derived from the presentations and discussion were summarized to create a proposed roadmap for advancement of technologies to support health and well-being. CONCLUSIONS: Technology to support precision health must be centered on the user and designed to be desirable, feasible, and viable. The proposed roadmap is composed of five iterative steps for the development, testing, and implementation of technology-based/enhanced self-management interventions. These steps are (a) contextual inquiry, focused on the relationships among humans, and the tools and equipment used in day-to-day life; (b) value specification, translating end-user values into end-user requirements; (c) design, verifying that the technology/device can be created and developing the prototype(s); (d) operationalization, testing the intervention in a real-world setting; and (e) summative evaluation, collecting and analyzing viability metrics, including process data, to evaluate whether the technology and the intervention have the desired effect. CLINICAL RELEVANCE: Interventions using technology are increasingly popular in precision health. Use of a standard multistep process for the development and testing of technology is essential.