Men's mental health - Conceptualization, effects, and coping.

Men are predisposed to suffer with unaddressed depression and anxiety. This study sought to empower men, in three urban, racially/ethnically diverse, underserved, and impoverished neighborhoods, for mental health self-care by capturing their perceptions of depression and anxiety. Using community-based participatory research, in the context of long-term partnerships between a department of nursing and these neighborhoods, the researchers recruited 50 men aged 23-83 years. Data were collected via six homogeneous, zoom-based focus groups composed of Black, Hispanic, and White men, respectively. The men identified themes pertaining to the conceptualization and devastating effects of depression and anxiety as well as coping strategies employed to mitigate the symptoms.

Capturing men's perspectives on prevalence, existing resources, and solutions to depression and anxiety using community-based participatory research and focus groups.

OBJECTIVE: Men are predisposed to suffer from unaddressed depression and anxiety. The purpose of this study was to capture the perceptions of men in three urban, racially/ethnically diverse, under-resourced, and impoverished neighborhoods around this health issue. The results were used to design a resident-driven solution to this health disparity. DESIGN: Design This study utilized a focus group method within the ideological perspective of community-based participatory research (CBPR). SAMPLE: Sample The researchers recruited 50 Black, Hispanic, and White men aged 23-83 years to participate in this study during the summer of 2021. MEASUREMENTS: Measurements Data were collected via six homogeneous, Zoom-based focus groups. Five of the focus groups were offered in English and the sixth in Spanish. RESULTS: The men identified themes and subthemes pertaining to the perception of widespread depression and anxiety in their neighborhoods, existing typical and atypical community resources, and suggested solutions to this health disparity. These results were translated into a solution involving the training of five male, lay mental health ambassadors. CONCLUSIONS: Policies and solutions to issues of mental health disparity must be informed by the communities that they intend to serve. CBPR is a robust vehicle for empowering communities to address the healthcare issues facing them.

Men's Depression and Anxiety: Contributing Factors and Barriers to Intervention.

BACKGROUND: Urban, ethnically/racially diverse, impoverished men are predisposed to experience unaddressed depression and anxiety. The overlap of these factors creates significant mental health inequity. AIMS: This study sought to capture men's impressions of the factors that contributed to their experience of depression and anxiety as well as barriers that they experienced in pursuing intervention. METHODS: Using community-based participatory research, in the context of long-term partnerships between a department of nursing and three urban, racially/ethnically diverse, and impoverished neighborhoods, the researchers recruited 50 men ages 23-83 years. Data were collected via six homogeneous, Zoom-based focus groups composed of Black, Hispanic, and White men, respectively. RESULTS: The men identified multiple themes pertaining to modifiable and non-modifiable contributing factors that played a role in their development of depression and anxiety as well as barriers related to stigma, resource issues, and a lack of knowledge of mental illness that they faced when seeking intervention. CONCLUSIONS: Understanding men's perspectives on the contributing factors and barriers to mental health intervention can provide an evidence base with which to address mental health inequity via tailored care, policy, and research agendas.

Women Supporting Women: The Use of Art With Anxious/Depressed, Urban, Impoverished, Ethnically Diverse Women.

BACKGROUND: Depression and anxiety disproportionately affect urban, ethnically diverse, impoverished women-particularly when access to culturally sensitive care is limited. Using community-based participatory research in the context of long-term, academic/community partnerships, women supporting women, a supportive/educative group intervention piloting an art project, was offered. AIMS: The purpose of this study was to examine the impact of an artist book-making project on diverse women struggling with anxiety and depression. METHODS: A descriptive qualitative approach was used within this mixed-method study. Thirty-one participants, aged 18 to 86 years, were asked: (1) How does this book tell your story? (2) How did creating this book impact you personally? (3) How would you describe the experience of creating your book alongside women from our group? (4) How did this project help you with anxiety and depression? (5) What did you do with the book that you made? The framework method for analysis of qualitative data in multidisciplinary health research was used. RESULTS: Four themes, with corresponding subthemes, were identified: (1) personal story entailed expression of past, present, and future journey and mediums to depict the story; (2) method of coping included relaxation, diversion, and self-care; (3) creative impact encompassed affirmation of identity, empowerment, healing, pride in work, and a vehicle to connect; and (4) creating in community incorporated inspiration, sharing, and solidarity. CONCLUSIONS: These results suggest that an art project provides a culturally sensitive, clinically relevant, and cost-effective self-care intervention for vulnerable women struggling with anxiety and depression.

Strategies to promote and sustain baccalaureate students' interest in pursuing a PhD degree in nursing.

PhD-prepared nurses are integral to the delivery of cost-effective, safe, and high-quality care to the increasingly diverse population in the U.S. Nurses with a PhD are needed to develop knowledge that informs and directs nursing care, promote positive health outcomes, and train the next generation of nurses and nurse scientists. Unfortunately, less than 1% of nurses have their PhD in nursing and there is an ongoing shortage of nurses in the U.S. that has not been effectively addressed. The PhD in nursing pipeline needs to be bolstered to address the escalating nursing shortage. This is especially important considering the importance of having an adequate number of well-prepared nurses to address the increasing complexities of health conditions and patient populations in the U.S. This paper presents strategies to promote and sustain interest in PhD in nursing among baccalaureate nursing students and discusses the importance of meaningful engagement in research and engaged faculty mentorship. It is important to incorporate research into undergraduate experiences, promote engaged mentorship during undergraduate level and beyond, and provide a conducive environment for undergraduate students to address their fears, misconceptions, and myths about PhD in nursing.

Factors impacting attrition of vulnerable women from a longitudinal mental health intervention study.

OBJECTIVE: This study explored factors associated with attrition of vulnerable women from a community-based, longitudinal mental health intervention study. DESIGN: The study employed a quasi-experimental, nonequivalent comparison group pretest-posttest design. The intervention consisted of six, 90-min meetings featuring education and support. SAMPLE: One hundred and eighteen women aged 18-88 years enrolled from four urban neighborhoods. MEASUREMENTS: The team used the Generalized Anxiety Disorder-7, the Primary Health Questionnaire-9, a self-care knowledge for anxiety and depression instrument, and demographics to measure variables. INTERVENTION: Sessions occurred at trusted neighborhood sites. The team provided transportation, child care, and reminder calls or texts. Community health workers actively encouraged participants to continue in the study. The researchers did not offer financial incentives. Completion of the intervention involved attending four of six sessions. RESULTS: The study had a 39% attrition rate. Results, using a Chi-square test for independence, indicated significant associations between attrition, neighborhood/homelessness, and family income. Additionally, there were significant associations between attrition, a past diagnosis of anxiety, and a lack of concurrent therapy for anxiety/depression. CONCLUSIONS: This study identified social determinants and mental health factors linked to the attrition of urban, ethnically diverse, and impoverished women from longitudinal intervention studies.

Women supporting women: Supportive/educative groups for ethnically diverse, urban, impoverished women dealing with depression and anxiety.

Depression and anxiety are mental health issues that disproportionately affect urban, ethnically diverse, impoverished women. Using community based participatory research and in the context of long-term partnerships between a nursing department and underserved neighborhoods that are predominately Black, Hispanic, and White respectively, supportive/educative groups were offered. The study employed a quasi-experimental, nonequivalent comparison group pretest-posttest design. Seventy-two women aged 17-88 years participated. Repeated measures ANOVA indicated a significant increase in knowledge for self-care for depression and anxiety and a significant decrease in anxiety and depression symptomatology from before to after the group sessions.

Promoting the Future of Nursing by Increasing Zest for Research in Undergraduate Nursing Students.

Nurses are expected to deliver cost-effective, high-quality care. In order to provide this care, nurse researchers are needed to evaluate and research effective health care models and interventions. By including research concepts within a baccalaureate nursing program, interest in nursing research can be increased. The purpose of this article is to present a case study of strategies used in an undergraduate liberal arts nursing program to promote zest in research and increase the pursuit of graduate studies among baccalaureate nursing students. Using the Bronfenbrenner ecological framework, the promotion of research is categorized into microsystems (individual), mesosystems (multiple setting), exosystems (program), and macrosystem (institutional culture) levels. The microsystem level includes engagement in the classroom, engagement in one-on-one meetings, and faculty members as role models. The mesosystem involves engagement outside the classroom and encouragement from faculty members. The exosystem level describes specific learning activities and programs the nursing department utilizes such as community assessments, preconception reproductive knowledge promotion, and women supporting women. Finally, the macrosystem includes a supportive and encouraging environment. By working together, each system contributes to the students' zest for nursing research and interest in graduate studies in nursing to pursue the role of a nurse researcher.

Preconception Health Behaviors of Low-Income Women.

PURPOSE: Preconception behaviors have a significant impact on birth outcomes, particularly among low-income minority groups, and women with unplanned pregnancies. This study examined women's perceived health status and behaviors such as drinking, smoking, exercise, and use of multivitamins and folic acid. STUDY DESIGN AND METHODS: This was a descriptive study based on a convenience sample of women living in urban underserved neighborhoods. Univariate and bivariate analyses were conducted using STATA 13. RESULTS: The sample consisted of 123 women ages 18 to 51 years (mean = 30.57); 51.22% were Hispanic, 36.59% African American, and 12.2% Caucasian. Over 70% had a household income of less than $20,000, 57.72% had no health insurance in the last year, and 58.54% were not married. These women were below the Healthy People 2020 goals for drinking, smoking, and multivitamin use, especially those who were planning to get pregnant in the next 6 months or not sure of their pregnancy planning status. There were no significant differences on any of the preconception health behavior variables based on pregnancy intention. CLINICAL IMPLICATIONS: Nurses and healthcare providers should emphasize importance of practicing healthy behaviors during the preconception period among low-income ethnic minority women specifically those living in urban medically underserved areas who are unsure of their pregnancy planning status or are at risk of unintended pregnancy.

Women's Knowledge of Ovulation, the Menstrual Cycle, and Its Associated Reproductive Changes.

BACKGROUND: The purpose of this study was to examine women's knowledge of female reproduction-anatomy, hormones and their functions, ovulation, the menstrual cycle and its associated reproductive changes, conception, and signs of pregnancy. METHODS: A survey was completed by 125 women of childbearing age as part of a larger "Women's Health Promotion Program." Descriptive statistics, mainly univariate and bivariate analyses were conducted using STATA 13. RESULTS: The women in the study were ages 18-51 years, 52.0 percent were Hispanic, 36.0 percent African American, and 12.0 percent White. The majority, 70.4 percent, had a household income of less than $20,000, 58.4 percent were not married, 83.2 percent were not trying to get pregnant at the time, and 37.6 percent had sexual intercourse that may have put them at risk for pregnancy in the past month. Less than one-third knew about the reproductive hormones. Over 80.0 percent knew their reproductive anatomy, 68.8 percent were not keeping any log to track their menstrual flow, 53.6 percent did not know when their next menstruation would be, and 49.6 percent did not know the average number of days for a regular menstrual cycle. Many did not know what ovulation is (47.2%), the ovulation timing (67.2%), the number of eggs released from an ovary each month (79.2%), and how long an egg or sperm could live in a woman's body (62.4%). CONCLUSIONS: Reproductive knowledge should be assessed during preconception visits and women should be taught comprehensive reproductive education-not just selected topics-to be adequately equipped to make informed reproductive decisions.

A Feasibility Study of Women's Confidence and Comfort in Use of a Kit to Monitor Ovulation.

INTRODUCTION: The focus of this study was to examine whether low-income adult women will use ovulation test strips, a menstrual calendar chart, thermometer, temperature graph, and cervical mucus assessment to monitor their ovulation time and other menstrual changes. Women's confidence in their ability to detect ovulation time and understand the menstrual cycle changes were also examined. METHODS: This is a descriptive study. Twenty-two low-income women aged 18 to 39 years living in medically underserved neighborhoods participated in this study. The women were introduced to and taught how to use a knowing your body (KB) kit, which consisted of ovulation test strips, monthly calendars for menstrual logs, digital thermometer for basal body temperature, and graphs to chart temperature. The women were interviewed 6 to 8 weeks later to confirm their experiences with the use of the KB kit. RESULTS: Ninety-one percent of the women used the ovulation test strips (mean, 3.8 strips); 77.3% were very to extremely confident that they could properly use the ovulation strip, 54.6% knew when they ovulated, and 31.8% could use the thermometer to confirm when they were ovulating. Seventy-three percent of the women were very to extremely comfortable using the ovulation test strips, 81.8% using the thermometer, 45.5% using the temperature graph, and 31.8% using the TwoDay Method (cervical mucus observation). DISCUSSION: The use of the ovulation test strip and other content of the KB kit provides a new opportunity for low-income women to learn about their bodies by monitoring their ovulation time and other menstrual changes as a pregnancy planning and early pregnancy recognition tool.

Impact of Integrating Community-Based Participatory Research Into a Baccalaureate Nursing Curriculum.

BACKGROUND: Community-based participatory research (CBPR) is rapidly gaining respect within the health care community as a means to promote public health and address health disparities. It has also recently been named as one of the competencies needed by public health professionals to be effective. METHOD: This article describes an educational innovation where CBPR is integrated into a baccalaureate nursing curriculum as a strategy to create meaningful learning experiences for nursing students while benefitting the health of the community. RESULTS: The impact of this approach was analyzed over a period of 12 years. The positive outcomes for the community, students, and faculty are described, along with the unique challenges. CONCLUSION: Integrating CBPR into a nursing curriculum is an innovation that is worthy of further assessment.

Conducting Research With Community Groups.

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. Although several barriers to conducting research with community groups exist, community-based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This article presents case studies that demonstrate how CBPR principles guided the development of (a) a healthy body weight program for urban, underserved African American women; (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women; and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research-intensive academic environments.

Attending to Communication and Patterns of Interaction: Culturally Sensitive Mental Health Care for Groups of Urban, Ethnically Diverse, Impoverished, and Underserved Women.

BACKGROUND: The United States is ethnically diverse. This diversity presents challenges to nurses, who, without empirical evidence to design culturally congruent interventions, may contribute to mental health care disparities. OBJECTIVE: Using Leininger's theory of culture care diversity and universality, this study documented communication and interaction patterns of ethnically diverse, urban, impoverished, and underserved women. DESIGN: Using a community-based participatory research framework, 61 Black, Hispanic, and White women participated in focus groups around their experiences with anxiety/depression. Researchers recorded verbal communication, nonverbal behavior, and patterns of interaction. RESULTS: The women's communication and interaction patterns gave evidence of three themes that were evident across all focus groups and five subthemes that emerged along ethnic lines. CONCLUSIONS: The results suggest cultural universalities and cultural uniquenesses relative to the communication and interaction patterns of urban, ethnically diverse, impoverished, and underserved women that may assist in the design of culturally sensitive mental health care.

Contraceptive use among low-income women living in medically underserved neighborhoods.

OBJECTIVE: To describe the rate of contraceptive use and types of contraception used by low-income women. DESIGN: A descriptive study was used to survey women about their contraceptive use and sexual behaviors 12 months prior to the time of the interview. PARTICIPANTS AND SETTING: A convenience sample of 110 low-income women living in three urban medically underserved neighborhoods who enrolled in a larger study was included. METHODS: Univariate and bivariate descriptive analyses were conducted using STATA 10. RESULTS: Forty-eight (43.6%) of the women were African American, 43 (39.1%) were Hispanic, and 17 (15.5%) were White. The women were age 18 to 55 years (Mean = 31 years). Forty percent of these women who were not pregnant or planning to get pregnant had sex without contraceptives in the past 12 months. The percentage of women who used contraception decreased from 77.3% users in the last 12 months to 63.6% current users. The most common methods used within the last 12 months were condom use by male partner (28.2%), birth control pills (14.6%), contraceptive injection (12.7%), intrauterine device (10.9%), and the patch (1.8%). CONCLUSIONS: Many of the low-income women from medically underserved neighborhoods did not use contraceptives and of those who used contraceptives, the majority used the least effective methods.

Using community-based participatory research to explore social determinants of women's mental health and barriers to help-seeking in three urban, ethnically diverse, impoverished, and underserved communities.

Depression and anxiety are significant mental health issues that affect urban, ethnically diverse, impoverished women disproportionately. This study sought to identify social determinants of mental health and barriers to help-seeking for this population. Using community based participatory research and focus groups, sixty-one Black, Hispanic, and White women identified economic, family, cultural, and neighborhood issues as perceived determinants of their depression/anxiety. They identified practical, psychosocial, and cultural barriers to their help-seeking behavior. These results can promote women's health by fostering an understanding of social factors as perceived determinants of depression/anxiety and shaping practice and policy initiatives that foster positive aggregate outcomes.

Teams of community health workers and nursing students effect health promotion of underserved urban neighborhoods.

OBJECTIVE(S): The purpose of this study was to explore the effectiveness of CHW/nursing student teams in promoting secondary protection and improving access to care for residents of three urban underserved neighborhoods. The study also sought to measure CHW and resident satisfaction of such a program. DESIGN AND SAMPLE: Quasi-experimental and non-experimental designs were used for the study. Convenience samples consisted of residents who participated in the CHW program during 2005-2006, CHWs and residents who participated in the CHW program during 2005-2007 and a systematic random sample of residents across the three neighborhoods. MEASURES: Three quantitative measures were used in the study: a pre/post test with residents who participated in the program, a satisfaction survey of CHWs and participants, and a community assessment survey of the neighborhoods in which the program occurred. RESULTS: CHW/nursing student teams were shown to increase awareness of community resources, increase access to dental care, decrease use of the ER, promote use of a medical home/regular source of care, and increase the percentage of people having their blood pressure screened in the last 2 years. CONCLUSION: CHW/nursing student teams can positively impact the health of underserved populations.

Low-income women's recommendations for promoting early pregnancy recognition.

INTRODUCTION: This study explored low-income women's perspectives on how to promote early recognition of pregnancy as one strategy to address community residents' concerns related to unintended pregnancy. Unintended pregnancy, which is more prevalent among low-income women and minorities, has been associated with various adverse pregnancy outcomes. METHODS: This study used the ideological perspective of community-based participatory research. Six focus groups were conducted in 3 low-income, urban, medically underserved neighborhoods with ethnically diverse populations. Neighborhood women who were either pregnant or had experienced a pregnancy within 3 years were invited to participate in the study. A structured interview guide focused the discussion on how to promote early recognition of pregnancy within the existing context of unintended pregnancies in the neighborhoods. Focus-group sessions were audiotaped, then transcribed verbatim; the data were analyzed using an open-coding template approach assisted by QSR NVivo 8 software. RESULTS: Forty-one women aged 18 to 44 years participated in the study. Thirty-nine percent were African American, 24.4% were Hispanic/Latino, 19.5% were American Indians, and 17.1% were white. Three primary themes were identified: 1) women should know the menstrual/ovulation and pregnancy-related changes that occur in their bodies; 2) women should be prepared to confirm their pregnancies early, as soon as they suspect they may be pregnant; and 3) both information and emotional support are needed for pregnancy-related issues. "Knowing your body" was the strongest advice to promote early recognition of pregnancy. DISCUSSION: The participants in this study suggested that education about reproductive changes should be initiated during early adolescence and in the preconception period. Early testing and confirmation of pregnancy should also be promoted, especially for women who have unprotected intercourse. Local resources for information and emotional support during pregnancy should be accessible to women.

Desired mental health resources for urban, ethnically diverse, impoverished women struggling with anxiety and depression.

Depression and anxiety are mental health issues that disproportionately affect women-particularly when access to culturally sensitive care is limited. The purpose of this study was to identify mental health concerns in three urban, ethnically diverse, underserved, and impoverished neighborhoods using the ideological perspective of community-based participatory research. In the context of long-term partnerships between a department of nursing and these neighborhoods, we recruited 61 women aged 18 to 69 years and collected data via homogeneous focus groups comprised of Black, Hispanic, and White women, respectively. We conducted five of the focus groups in English and one in Spanish. The women perceived anxiety and depression as significant concerns for themselves, their families, and their communities. They used unique community resources to manage mental health issues and desired new resources, including support groups and education.

Clinging to any bit of joy: urban, ethnically diverse, impoverished women's descriptions of anxiety and depression.

Depression and anxiety are mental health issues that disproportionately affect women. This study sought to capture perceptions of anxiety and depression in 3 urban, ethnically diverse, underserved, and impoverished neighborhoods. Using community-based participatory research, in the context of long-term partnerships between a department of nursing and these neighborhoods, the researchers recruited 61 women aged 18 to 69 years. Data were collected via 6 homogeneous focus groups composed of Black, Hispanic, and White women, respectively. The women identified themes pertaining to the manifestations and effects of anxiety and depression as well as unique coping strategies.