Equipping Nurse Practitioner Students With Social Determinants of Health Competencies.

BACKGROUND: Social determinants of health (SDOH) cause significant burden on individuals living with acute and chronic disease. There are meaningful data to support screening for social needs, yet implementation limitations exist in the clinical setting. Incorporating SDOH education into nurse practitioner (NP) curriculum provides a framework for bringing these concepts into clinical practice. As NP education transitions from concept-based to competency-based instruction, NP programs across the nation are tasked with ensuring socially competent, practice-ready NPs. METHOD: To help students understand the impact of SDOH in an applied way, a multisemester clinical and didactic dyad approach to SDOH competency was implemented. RESULTS: NP students (N = 521) in three separate cohorts completed the SDOH project between 2019 and 2021. Statistically significant results (p > .001) demonstrated increased knowledge related to SDOH in the clinical setting. CONCLUSION: Equipping NP students with SDOH competencies empowers them to optimize health, improve patient outcomes, and promote health equity. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Using the Personalized Advantage Index to determine which veterans may benefit from more vs. less comprehensive intensive PTSD treatment programs.

Background: Intensive PTSD treatment programs (ITPs) are highly effective but tend to differ greatly in length and the number of adjunctive services that are provided in conjunction with evidence-based PTSD treatments. Individuals' treatment response to more or less comprehensive ITPs is poorly understood.Objective: To apply a machine learning-based decision-making model (the Personalized Advantage Index (PAI)), using clinical and demographic factors to predict response to more or less comprehensive ITPs.Methods: The PAI was developed and tested on a sample of 747 veterans with PTSD who completed a 3-week (more comprehensive; n = 360) or 2-week (less comprehensive; n = 387) ITP.Results: Approximately 12.32% of the sample had a PAI value that suggests that individuals would have experienced greater PTSD symptom change (5 points) on the PTSD Checklist for DSM-5 in either a more- or less comprehensive ITP. For individuals with the highest 25% of PAI values, effect sizes for the amount of PTSD symptom change between those in their optimal vs. non-optimal programs was d = 0.35.Conclusions: Although a minority was predicted to have benefited more from a program, there generally was not a substantial difference in predicted outcomes. Less comprehensive and thus more financially sustainable ITPs appear to work well for most individuals with PTSD.

A Personalized Advantage Index (PAI) was developed for a 3-week (more comprehensive) and a 2-week (less comprehensive) intensive PTSD treatment program to predict treatment responses.Using the PAI, approximately 12% of the sample was predicted to have experienced meaningfully greater in another program than the one in which they participated.Findings suggest a less comprehensive and more financially sustainable 2-week intensive PTSD treatment program would work well for most veterans in the present study.

Meta-analyses of teacher-delivered trauma-based and trauma-informed care interventions.

OBJECTIVE: Children impacted by adversity and trauma often experience psychological, emotional, behavioral, and academic difficulties. To address these concerns, there is a growing call for trauma-informed school systems to better support students with trauma histories. Teacher involvement in trauma-informed approaches is vital but understudied. METHOD: We conducted a meta-analytic review of the literature published between 1990 and 2019 to evaluate outcomes for teachers and students involved in teacher-delivered trauma interventions. Inclusion criteria specified peer-reviewed studies, dissertations, and nonacademic reports that used randomized controlled and nonrandomized pre-post intervention designs. RESULTS: We found 20 articles, of which, 12 were pre-post and eight were randomized designs. Seven articles specifically incorporated trauma-informed care (TIC), whereas the other 13 were traditional trauma-based mental health interventions. We conducted meta-analyses to assess student trauma symptom severity and teacher knowledge of trauma-informed practices. Results revealed that after participating in teacher-delivered trauma interventions, students reported significantly reduced trauma symptom severity postintervention and less severity of symptoms than students in the control conditions. There were no differences between trauma-based and TIC intervention student outcomes. Teachers exhibited greater knowledge acquisition after participating in TIC interventions. CONCLUSION: These findings suggest that trauma interventions, both with and without explicitly referencing TIC principles, are evidence-based in the context of teacher-facilitated school interventions. Additional research is needed to evaluate the organizational benefits of TIC, particularly to determine if the benefits of trauma-informed schools extend beyond students. We conclude with research, policy, and practice recommendations for transformative change to create trauma-informed schools. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gamification of Primary Care in a Baccalaureate Nursing Education Program.

ABSTRACT: A grant-funded undergraduate nursing elective was designed to increase the bachelor of science in nursing-prepared nursing workforce in primary care. We created a board game to engage students to address complex needs of clients in primary care. Using patient scenario game cards, students identify and discuss levels of prevention, social determinants of health, and resiliency principles as they move along the board. Gamification challenges students to think critically and make decisions about primary care patient scenarios in a safe learning environment. Potential uses for gamification to teach students management of complex patient scenarios are identified.

Rape Crisis Victim Advocacy: A Systematic Review.

While rape crisis center (RCC) advocacy is generally regarded as valuable, there are no prior systematic reviews of the advocacy literature. This review examined RCC advocacy service provision, perceptions and impact of advocacy, and challenges and facilitators to effective service provision. Databases related to health and social sciences were searched including Academic Search Complete, PsychINFO, PubMed, CINAHL, ProQuest, Science Direct, OAlster, WorldCat, and MEDLINE. Empirical articles written in English that examined RCC advocacy service provision and/or impact in the US were included. The researchers reviewed abstracts and titles, and then full texts. Forty-five articles met criteria, were summarized, and double checked. Findings demonstrate advocacy is multi-faceted, beneficial, and challenging. Advocates work directly with survivors and interact with other responders on behalf of survivors. Specifically, advocates provide emotional support, safety plan, support survivors in making decisions, and assist them in navigating other systems. While advocates are generally regarded positively by survivors and responders, some responders have concerns about advocates. In addition, advocates sometimes report victim-blaming and being ill-equipped to meet survivors' needs. Finally, advocates face specific challenges in their work with survivors and responders. Future research using diverse methodological approaches is needed to understand advocacy utilization and reach; survivors' perceptions of advocacy; marginalized survivors' experiences; connections between specific services, implementation, and outcomes; and effective strategies for advocates' interactions with other responders. Additional resources to help advocates serve all survivors effectively and equitably; to support evaluator-practitioner partnerships; and to share unpublished data on advocacy may help contribute to improvements in advocacy practice.

Implementation of a Registered Nurse Primary Care Clinical Mentoring Academy.

Registered nurses (RNs) are pivotal team members for improving the quality of care in communities; however, they are underutilized in primary care. Two schools of nursing in Alabama partnered to develop and implement a project to build a resilient primary care RN workforce. A major component of this project is the Primary Care Clinical Mentoring Academy (PCCMA), which was designed to prepare RN clinical mentors to implement positive student learning experiences in the primary care setting. The PCCMA follows a comprehensive curriculum implementing both didactic instruction and interactive activities related to primary care competencies; interprofessional education and collaborative practice; and primary care RN mentor roles and responsibilities. Participants reported that the PCCMA was effective and useful, and they perceived that it would improve their overall job performance as a clinical mentor. The PCCMA is an effective way to produce confident and capable RN mentors in primary care. [J Contin Educ Nurs. 2022;53(7):312-320.].

COVID-19 Telehealth Fair Partnership for Capacity Building in Primary Care Nursing.

Telehealth in health care delivery grew exponentially throughout the COVID-19 pandemic. This growth occurred because of necessity, yet requires capacity building to maximize the technology's use. In this article, we discuss the development, implementation, and evaluation of a telehealth fair to build capacity in the use of telehealth technology within primary care nursing. The telehealth fair consisted of didactic and simulation components. Undergraduate and graduate nursing students completed the telehealth fair supported by a team of 12 nursing faculty and 6 clinical partner sites. Findings suggest statistically significant increases in student self-assessment of knowledge in telehealth, self-confidence in the use of telehealth, and readiness in the use of telehealth technology. Participant satisfaction following completion of the telehealth fair was high, with average scores of 4.2 to 4.58 (out of 5) for the didactic and 4.57 to 4.86 for the simulation components. The telehealth fair provided an invaluable opportunity for participants to enhance their learning relative to telehealth within primary care nursing. The experience also provided an opportunity for students to gain clinical hours during a pandemic when clinical placements in the community were limited. The experience also enhanced telehealth practice readiness of nursing students entering the workforce.

Curricular and Clinical Innovation Engaging Undergraduate Nursing Students to Build a Resilient Primary Care Workforce.

BACKGROUND: Primary care health settings provide access to services for underserved populations, yet baccalaureate (BSN)-prepared nurses are currently underutilized on the primary care health care team. PROBLEM: BSN curricula often focus on acute care settings for clinical experiences, and students may not be aware of the scope and impact the RN has in a primary care setting. This gap in experiences may lead to overlooking primary care employment opportunities. PURPOSE: The purpose of this article is to describe the development, implementation, and evaluation of an innovative course that builds the primary care nurse workforce capacity. APPROACH: An undergraduate elective course focusing on primary care didactic and clinical experiences was created. OUTCOMES: Qualitative student feedback regarding the course was positive, while quantitative data revealed an above-average course outcome rating. CONCLUSIONS: An effective intervention to increase workforce capacity in primary care settings is to immerse students in primary care concepts and experiences in a formal, combined didactic and clinical course.

Here's looking at you, kid? Maternal depression and adolescent attention to self- or other-directed emotional faces.

BACKGROUND: Maternal depression history represents a significant risk factor for developing psychopathology in children, altered emotional responding may represent a central risk pathway. However, additional research is needed on factors that affect the strength or direction of response alterations in relation to depression-risk in youth. In particular, facial orientation and gaze direction may alter personal relevance, with emotions directed towards an individual heightening motivational salience, compared to emotions directed away. METHODS: Mother-daughter dyads (N = 56) were recruited based on presence or absence of maternal depression history and absence of youth depression. In line with theoretical perspectives suggesting diminished sensitivity to emotional context in relation to depression risk, we examined three Event-Related Potential (ERP) components in relation to forward versus averted emotional faces in a sample of girls with and without a maternal history of depression: the N200, N400, and Late Positive Potential (LPP). RESULTS: Results showed a significant maternal depression history by face-orientation effect. Low-risk girls exhibited more negative N200 and N400 amplitudes for straight (M = -3.72, SE = 0.83; M = -3.57, SE = 0.86) versus averted (M = -2.15, SE = 0.76; M = -1.68, SE = 0.81) faces, while girls of mothers with histories of depression showed undifferentiated N200 or N400 responses in relation to face orientation. For LPP amplitudes, low-risk girls exhibited significantly more positive LPP amplitudes than high-risk girls, but only for averted faces (M = 0.69, SE = 0.59 and M = -2.63, SE = 0.74, respectively). LIMITATIONS: Cross-sectional design and limited sample. CONCLUSIONS: Results indicate that familial depression risk is associated with altered responsivity to face-orientation, these were interpreted as representing differential sensitivity to the personal-relevance of emotional stimuli.