A Scoping Review of Cervical Cancer Risk Factors, Prevention, Diagnosis, and Treatment in U.S. Active Duty Military Women.

INTRODUCTION: Maintaining military readiness requires integration and delivery of appropriate sex-specific health care services for active duty servicewomen (ADSW). Cervical cancer screening (CCS) provides early detection, intervention, and treatment, allowing for reductions in human papillomavirus (HPV) infections and cervical cancer cases. This scoping review examines existing cervical cancer evidence related to ADSW and identifies research gaps, leverage points, and policy recommendations within the context of the social ecological model for military women's health. METHODS: We conducted a scoping literature search using both indexed databases and nonindexed sources. We managed retrieved records from 2000 to 2018 with Endnote reference and DistillerSR systematic review software. RESULTS: Of 1,006 records from indexed databases and 208 records from nonindexed resources retrieved, 40 publications met the inclusion criteria. Cervical cancer research addressing ADSW is limited. Servicewomen have high rates of known cancer risk factors and face challenges related to deployments and change of duty station that affect continuity of health care and timely follow-up for abnormal CCS. Multimodal interventions with stakeholder support can encourage CCS adherence and increase HPV vaccination rates. CONCLUSION: Maintaining military readiness among ADSW requires robust evidence-based prevention efforts to address risk factors that are reportedly higher among servicewomen, as well as challenges to continuity in health care delivery that may increase the likelihood of cervical cancer incidence. Recognizing the role of HPV vaccination as cancer prevention, collaborations and partnerships, research, best practices, and creative solutions to close ADSW's sex-specific health gaps will help to ensure a fit and ready force.

Female warfighters' perceptions of urogenital health in operational settings.

BACKGROUND: An increased incidence in hygiene-related urogenital infections (bacterial vaginitis, vulvovaginal candidiasis, and urinary tract) has been reported in female warfighters serving in austere environments with decreased availability of water and sanitation resources, and when personal safety outweighs concerns for hygiene. Knowledge and access to an innovative kit designed for the female warfighter to self-test, self-identify, and self-treat common urogenital symptoms is critical to force health. PURPOSE: The purpose of this descriptive, cross-sectional, exploratory qualitative study was to explore female warfighters': 1) confidence in seeking sex-specific health care in field and deployment environments and 2) acceptance and willingness to self-test, self-identify, and self-treat urogenital symptoms and infections. METHODOLOGICAL ORIENTATION: Qualitative data for this thematic analysis were collected during administration of the Military Women's Readiness Urogenital Health Questionnaire. Participants provided open-ended comments associated with three survey questions. Braun and Clarke's inductive thematic analysis method guided the narrative analysis. SAMPLE: Our sample included a diverse group of US Army women (USAW; n = 152) from a large, military installation. RESULTS: Narratives and themes demonstrate USAW's desire and need for the availability of a self-test and self-treatment kit. Access, time, mission, and prevention of self-harm by quicker resolve of symptoms are cited as key reasons in support of such a kit. CONCLUSIONS AND PRACTICE IMPLICATIONS: Nurse practitioners (NPs) are ideally positioned to provide sex-specific educational interventions and anticipatory guidance that supports physical health, to include urogenital conditions. As urogenital self-testing becomes available for female warfighters, NPs are the model healthcare provider for educating women on their use.

An integrative review of nurse practitioner education models: Part three of a four-part series on critical topics identified by the 2015 Nurse Practitioner Research Agenda.

BACKGROUND AND PURPOSE: Critical research topics were identified after nurse practitioner (NP) organization stakeholders participated in the Fellows of the American Association of Nurse Practitioner, 2015 Nurse Practitioner Research Agenda Roundtable. Strategies and recommendations were identified to support further work examining NP outcomes-based research priorities in four areas: 1) policy and regulation; 2) workforce; 3) education; and 4) practice. For the purpose of this article, we focus on NP education. Important contrasts became evident after critiquing, analyzing, and synthesizing the literature. Meaningful differences were discovered in the understanding of the complexity of the construct, NP Education Models. Our results are presented as an integrative review. This is the third article in a four-part series investigating FAANP research priorities. METHODS: A systematic literature review summarizing the literature for NP Education Models was conducted. PRISMA evidence-based methods were used to identify relevant studies. Of the 3,374 studies identified, 133 duplicate studies were eliminated, yielding a total of 3,241 articles. A team of three reviewers conducted screening and reviewing processes using defined eligibility criteria. CONCLUSIONS: A lack of clarity regarding use of the construct, NP Education Models, was discovered. The construct was broadly defined and represented different meanings. There is a paucity of theoretical development in current NP education that should be core to practice-focused NP educational programs. IMPLICATIONS FOR PRACTICE: Theoretical and conceptual NP education models and frameworks would bridge the gap between practice- and research-focused graduate programs. Overarching theoretical and conceptual models and frameworks promote critical thinking and decision-making across settings and populations.