Advancing family science and health equity through the 2022-2026 National Institute of Nursing Research strategic plan.

BACKGROUND: Consistent with the National Institute of Nursing Research's mission of leading nursing research to address current health challenges, the new Strategic Plan identifies five research lenses: health equity, social determinants of health, population and community health, prevention and health promotion, and systems and models of care. Family research, central to nursing research and practice, is the cornerstone of social ecology and represents a critical intersection of social and structural determinants of health. PURPOSE: We argue why family health is essential to the 2022-2026 Strategic Plan and how the lenses can strengthen family research. METHODS: Drawing from collective expertise and existing literature in family research, sociology, psychology, and nursing science, the authors present a new conceptual model that integrates structural racism and heteropatriarchy to examine the salience of family structure statuses for family outcomes and discuss approaches to research design, empirical measurement, and interpretation in order to bring this new model into practice. DISCUSSION: The NINR Strategic Plan has the potential to dismantle structures that perpetuate racism and health inequity within and across family structures. An underaddressed research area under the new Strategic Plan relates to how social determinants of health influence and are influenced by families. CONCLUSION: We challenge all investigators, not just family scientists, to expand the scope of their research to conceptualize the role of family on health inequities.

"Should I stay or should I go?" Nurses' perspectives about working during the Covid-19 pandemic's first wave in the United States: A summative content analysis combined with topic modeling.

BACKGROUND: The COVID-19 pandemic had its first peak in the United States between April and July of 2020, with incidence and prevalence rates of the virus the greatest in the northeastern coast of the country. At the time of study implementation, there were few studies capturing the perspectives of nurses working the frontlines of the pandemic in any setting as research output in the United States focused largely on treating the disease. OBJECTIVE: The purpose of this study was to capture the perspectives of nurses in the United States working the frontlines of the COVID-19 pandemic's first wave. We were specifically interested in examining the impact of the pandemic on nurses' roles, professional relationships, and the organizational cultures of their employers. DESIGN: We conducted an online qualitative study with a pragmatic design to capture the perspectives of nurses working during the first wave of the United States COVID-19 pandemic. Through social networking recruitment, frontline nurses from across the country were invited to participate. Participants provided long form, text-based responses to four questions designed to capture their experiences. A combination of Latent Dirichlet Allocation--a natural language processing technique--along with traditional summative content analysis techniques were used to analyze the data. SETTING: The United States during the COVID-19 pandemic's first wave between May and July of 2020. RESULTS: A total of 318 nurses participated from 29 out of 50 states, with 242 fully completing all questions. Findings suggested that the place of work mattered significantly in terms of the frontline working experience. It influenced role changes, risk assumption, interprofessional teamwork experiences, and ultimately, likelihood to leave their jobs or the profession altogether. Organizational culture and its influence on pandemic response implementation was a critical feature of their experiences. CONCLUSIONS: Findings suggest that organizational performance during the pandemic may be reflected in nursing workforce retention as the risk for workforce attrition appears high. It was also clear from the reports that nurses appear to have assumed higher occupational risks during the pandemic when compared to other providers. The 2020 data from this study also offered a number of signals about potential threats to the stability and sustainability of the US nursing workforce that are now manifesting. The findings underscore the importance of conducting health workforce research during a crisis in order to discern the signals of future problems or for long-term crisis response. TWEETABLE ABSTRACT: Healthcare leaders made the difference for nurses during the pandemic. How many nurses leave their employer in the next year will tell you who was good, who wasn't.

Experiences of Adult Men Who Are Homeless Accessing Care: A Qualitative Study.

INTRODUCTION: Homeless individuals experience increased rates of chronic physical and mental health conditions. They also experience difficulty accessing care and poor health outcomes compounded by social and economic factors, such as housing insecurity, unemployment, and limited social support. The purpose of this study was to describe the perceptions of homeless individuals related to their health and experiences accessing care. METHOD: Qualitative descriptive methods and content analysis were used to gather, analyze, and interpret the data and identify themes. RESULTS: Three themes were identified: men who are homeless experience bias throughout their health care and interpersonal relationships, the best care is person-centered and considers patients' priorities, and care coordination resources are inadequate. DISCUSSION: The housing needs of homeless individuals are best contextualized by their health and social needs. In addition, their priorities must be taken into consideration to develop culturally congruent services that are appropriate and effective care for this population.