Testing a Talkstory Intervention to create Supportive and Safe Violence-Free Communities for Women.

The purpose of this paper is to report on a community-designed and led talkstory intervention to increase awareness of intimate partner violence (IPV), decrease acceptability of IPV, and increase community leadership to address IPV. In collaboration with women engaged in prior IPV outreach and education in Hawai'i, a talkstory intervention for IPV was developed, and a single-group, pre-post-test design was used to test it. The intervention included five talkstory sessions over seven months with community groups interested in violence prevention. Pre- and post-testing were conducted to determine changes in group means on three measures. Ninety-two individuals participated in the intervention, 77 (84%) of these completed the 1-month follow-up measure, and 59 (64%) of these also completed the 6-month follow-up measure. The findings included: (1) participants in the talkstory intervention groups decreased their acceptability of violence and increased their awareness, knowledge, and confidence to address IPV; (2) the community leaders in the intervention groups gained skills in facilitation; and (3) intervention groups continued to sponsor other IPV awareness-raising activities in their communities following completion of the study. Working with community leaders to design and facilitate the intervention not only provided IPV education within the context of the community, but also led to sustainable efforts to enhance the safety and wellbeing of women experiencing violence.

Engaging Native Hawaiians and Pilipinos in creating supportive and safe violence-free communities for women through a piloted "talkstory" intervention: Implications for program development.

In Hawaii, 20% of women have been victims of intimate partner violence (IPV). Although disaggregated data specific to Native Hawaiians or Pilipinos (The official Filipino language recognizes both Filipino (Filipina) and Pilipino (Pilipina) as terms for the citizens of the country. Participants in this study chose to use the terms Pilipino (Pilipina). Retrieved from: www.pilipino-express.com/history-a-culture/in-other-words) are limited, greater than 70% of women murdered in Hawaii as a result of IPV are Pilipino or native Hawaiian. A consortium was formed to assist Native Hawaiian and Pilipino women addressing abuse and strengthening support from the community. A quasi-experimental community-based participatory research study was designed to assess a community "talkstory" intervention for IPV. "Talkstory" refers to informal gatherings considered to be a laid-back conversation involving a "reciprocal exchange of thoughts, ideas, feelings about self, and other issues" (Affonso et al., 1996. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 25, 738). This article describes the development of an intervention to address IPV in Hawaii and presents the findings obtained from the pilot studies. Results from the pilot study were used to modify the proposed "talkstory" intervention, revise the data collection tools, and provide the program developers with insights into how the community viewed IPV. The most significant change was an increased perception of their awareness, knowledge, and confidence to address IPV following the intervention.

Responding to the needs of culturally diverse women who experience intimate partner violence.

This paper presents the findings from a community based participatory research (CBPR) study that investigated the interface between culture and intimate partner violence (IPV) for women in selected cultural groups in Hawaii: Native Hawaiian, Filipino, Samoan, and Chuukese. The research question was, "What are the cultural perceptions, responses, and needs regarding IPV of selected individuals and groups served through a variety of programs that are affiliated with the three participating Community Health Centers (CHCs)?" This cross sectional, descriptive study collected both qualitative and quantitative data. Individual interviews were conducted with women who had experienced IPV. Focus groups were also conducted with other women from the same culture. Five common themes were identified across the four cultural groups: Living within a Collective; Cultural Protective Factors; Cultural Barriers to Helpseeking; Gender Specific Roles; and Belonging to a Place. The outcome from this study is increased knowledge that will be used to develop culturally appropriate interventions. Specific findings from each cultural group have been published. The purpose of this paper is to present common perceptions and responses to IPV from the four groups and suggest interventions based on the findings. Implications for practice are presented.

Listening to Filipina women: perceptions, responses and needs regarding intimate partner violence.

Interpersonal violence (IPV) is a complex issue effecting women worldwide. Reported rates of IPV vary widely from one cultural group to another (Magnussen et al., 2004 ; Tjaden & Thoennes, 2000 ). This paper presents a community based participatory research (CBPR) study of the perceptions, responses, and needs of Filipina women regarding IPV. Data was collected by using interviews and focus groups. The women believed that it was their responsibility to keep the family intact regardless of IPV and did not realize that IPV has a significant negative impact on the mental health and well-being of both women and their children. Immigrant Filipino women may be particularly at risk of IPV.

The Voices of Native Hawaiian Women: Perceptions, Responses and Needs Regarding Intimate Partner Violence.

Using a community based participatory approach, individual interviews and focus groups were conducted with Native Hawaiian women to understand their cultural perceptions, responses, and needs regarding intimate partner violence (IPV). Semi-structured interview guides were used for both interviews. The overriding theme derived from content analysis is that IPV "starts in the home," it is learned in the family and in the community. Visible injuries requiring emergency care is commonly perceived as IPV. The response to IPV included a primary theme of "defend the collective." Intimate partner violence is understood to be a "family matter," dealt within the family or by oneself. Native Hawaiian women who participated in this study sought to re-connect or establish relationships with self, others, spirit, natural elements, cultural practices, and community. Responding to IPV requires an understanding of cultural perceptions, responses, and needs of Native Hawaiians, with implications for families and communities. The needs expressed by Native Hawaiian participants reflect what they need to access "health." Implications for health care providers require understanding how best to facilitate an individual's access to "health" vs. access to "health care."

Emotional intelligence, performance, and retention in clinical staff nurses.

BACKGROUND: Emotional intelligence has been correlated with performance, retention, and organizational commitment in professions other than nursing. A 2006 pilot study provided the first evidence of a correlation between emotional intelligence and performance in clinical staff nurses. A follow-up study was completed, the purpose of which was to explore emotional intelligence, performance level, organizational commitment, and retention. METHODS: A convenience sample of 350 nurses in a large medical center in urban Hawaii participated in this study. This article reports the findings pertaining to the subset of 193 clinical staff nurses who responded. The Mayer-Salovey-Caruso Emotional Intelligence Test instrument was used to measure emotional intelligence abilities. Performance was defined as ranking on a clinical ladder. Commitment was scored on a Likert scale. The following variables measured retention: total years in nursing, years in current job, total years anticipated in current job, and total anticipated career length. CONCLUSIONS: Emotional intelligence scores in clinical staff nurses correlated positively with both performance level and retention variables. Clinical staff nurses with higher emotional intelligence scores demonstrated higher performance, had longer careers, and greater job retention.

Intimate partner violence screening and pregnant Latinas.

Little is known about factors associated with health care screening of intimate partner violence (IPV) for Latinas during pregnancy. This study builds on current research examining IPV-associated outcomes among Latinas by analyzing 210 pregnant Latina responses to a patient survey. A multivariate logistic regression model examined factors associated with being screened for IPV. One-third of pregnant women reported being screened for IPV. Factors related to being screened for IPV are reported and did not match those associated with having experienced IPV. While most pregnant Latinas were not screened for IPV, having systematic processes in place for IPV screening and fostering good patient-provider communication may facilitate identification of IPV. Having a greater awareness of the risk factors associated with IPV may also provide cues for clinicians to better address the issue of IPV.

Intimate partner violence: perceptions of Samoan women.

UNLABELLED: The purpose of this study was to examine cultural perceptions, awareness, responses, and actions recommended about IPV by Samoan women served by a Community Health Center (CHC). THEORETICAL FOUNDATION: This investigation is a part of a series of exploratory community based participatory research (CBPR) studies based on critical social theory. RESEARCH DESIGN AND METHODS: This qualitative study was conducted using focus groups with Samoan women served by a health center. Analysis of qualitative data was accomplished using content analysis. Demographic data were analyzed using descriptive methods. PARTICIPANTS: Eight Samoan women, 18 years and older participated in the focus groups. PROCEDURE: The instruments were translated from English to Samoan and back translated into English. The facilitators conducted an initial focus group and a validation group with the same participants. Sessions were taped and transcribed in Samoan and back translated into English. RESULTS: The women clearly identified IPV and were aware that it occurs in their cultural group. They identified multiple responses of individual women, families, and communities to IPV. In Samoa there was a formalized process for addressing this problem that has been changed in Hawai'i. The CHCs are viewed as an important resource for the families and can be a source of interventions. IMPLICATIONS: Health care providers should be aware of differences between Western notions of independence and the ideals of interdependence held by specific cultural groups. The CHC personnel have raised questions about the appropriateness of using tools that were developed for use with Western women with immigrant women.

Measuring the emotional intelligence of clinical staff nurses: an approach for improving the clinical care environment.

BACKGROUND: Significant correlations have been demonstrated between emotional intelligence (EI) and high levels of performance and other organizational variables related to retention and workplace environment. Although these variables are also important for safe care and healthy work relationships, there is little research on the EI of clinical staff nurses. The purpose of this study was to measure EI as related to performance level of clinical staff nurses, and to collect data on important related career/organizational variables. METHODS: Thirty-six nurses in 3 urban hospitals in Honolulu, Hawaii, participated. EI, nursing performance level, and career/organizational variables were measured. DISCUSSION: Significant positive correlations between clinical performance level and EI scores were observed. However, a large percentage of the clinical staff demonstrated below average total EI scores and subscores (perceiving emotions, experiencing emotions). CONCLUSIONS: Findings from this study offer the first evidence that the performance level of clinical staff nurses correlates positively with EI. A high percentage of nurses in this study scored below average on both total EI score and important subscores. These findings warrant further investigation. EI may offer a framework and specific skills to enhance collaboration, positive conflict behaviors, and healthy relationships in the clinical care environment.

Intimate partner violence: perceptions of Chuukese women.

PURPOSE: This qualitative study examined Chuukese women's views about Intimate Partner Violence (IPV). METHODS: Focus groups were conducted in Chuukese. Themes emerged from content analysis. RESULTS: Migration may disrupt protective cultural practices. Cultural norms place the responsibility for family peace on the women who perceive that IPV is closely linked with marital infidelity. IMPLICATIONS: Understanding cultural practices is important in addressing IPV.

Generating science by training future scholars in nursing research addressing the needs of vulnerable populations.

This chapter focuses on the National Institutes of Health (NIH) T32 National Research Service Award (NRSA) funding mechanism, designed to enhance the development of nurse scientists. The general history and principles underlying NIH funding for T32s as well as the National Institute of Nursing Research's (NINR) involvement in the NRSA program is described, highlighting the University of California Los Angeles School of Nursing's T32 training program in vulnerable populations research and the program and career trajectory data from close to two-thirds of NINR-funded T32s directors. Recommendations for the improvement of NINR-funded T32 training programs are identified. Findings include the need for increased collaboration between institutions receiving T32 funding from the NINR.

Identifying emotional intelligence in professional nursing practice.

The National Center for Health Workforce Analysis projects that the shortage of registered nurses in the United States will double by 2010 and will nearly quadruple to 20% by 2015 (Bureau of Health Professionals Health Resources and Services Administration. [2002]. Projected supply, demand, and shortages of registered nurses, 2000-2020 [On-line]. Available: http:bhpr.hrsa.gov/healthworkforce/reports/rnprojects/report.htm). The purpose of this study was to use the conceptual framework of emotional intelligence to analyze nurses' stories about their practice to identify factors that could be related to improved nurse retention and patient/client outcomes. The stories reflected evidence of the competencies and domains of emotional intelligence and were related to nurse retention and improved outcomes. Nurses recognized their own strengths and limitations, displayed empathy and recognized client needs, nurtured relationships, used personal influence, and acted as change agents. Nurses were frustrated when organizational barriers conflicted with their knowledge/intuition about nursing practice, their communications were disregarded, or their attempts to create a shared vision and teamwork were ignored. Elements of professional nursing practice, such as autonomy, nurse satisfaction, respect, and the professional practice environment, were identified in the excerpts of the stories. The shortage of practicing nurses continues to be a national issue. The use of emotional intelligence concepts may provide fresh insights into ways to keep nurses engaged in practice and to improve nurse retention and patient/client outcomes.

Finding solutions to challenges faced in community-based participatory research between academic and community organizations.

Partnerships between communities and academic institutions have been vital in addressing complex health and psychosocial issues faced by culturally diverse and hard-to-reach populations. Community-based participatory research (CBPR) has been suggested as a strategy to develop trust and build on the strengths of partners from various settings to address significant health issues, particularly those persistent health issues that reveal disparities among minority populations. There have been many challenges to developing these partnerships in the United States. The purpose of this paper is to discuss approaches and solutions used by this research team in response to the challenges they have faced in using CBPR. The team uses CBPR to understand and support the process of disclosure of intimate partner violence (IPV) within the context of the community health centers that provide services for multicultural and multi-lingual populations. While CBPR provides a route to develop trust and build on the strengths of partners from various settings, there are multiple challenges that arise when partnering organizations present with different infrastructures, missions, resources and populations served. Examples of common challenges and solutions from the literature and from the team's experience will be discussed. Implications for partners, partnerships, practice and research will be explored.

Reducing health disparities by improving quality of care: lessons learned from culturally diverse women.

Disparities in health care for culturally diverse populations in the United States lead to poorer health outcomes. This article focuses on decreasing health disparities by improving the quality of care for culturally diverse women. Findings from 3 pilot studies are organized using Fongwa's Quality of Care Model, which demonstrate specific modifications suggested by culturally diverse women that can potentially improve health care services for these women.

Listening to women: culturally tailoring the violence prevention guidelines from the put prevention into practice program.

PURPOSE: To develop five reliable and valid (culturally tailored) guidelines focused on the prevention of violence as presented in the violence prevention guideline of the Put Prevention into Practice Clinician's Handbook on Preventative Services (PPIP). DATA SOURCES: The data collection for this qualitative, descriptive design of naturalistic inquiry was focus group interviews with five different ethnic groups of women (Caucasian, Filipino, Hawaiian, Japanese and Hispanic) using a semi-structured interview guide. CONCLUSIONS: The women interviewed provided a variety of suggestions for adaptations to the guideline. Cultural similarities and differences are presented. Development of a nonjudgmental and trusting relationship is key to disclosure. IMPLICATIONS FOR PRACTICE: Violence against women is recognized as a major public health problem. Little is known about the effectiveness of standardized interventions such as those contained in the PPIP Handbook. Even less is known about the efficacy of such protocols within culturally diverse populations. Providers should consider adaptation of the guideline based on the individual relationship with the client. The next phase of this research is to implement the culturally tailored adaptations of these guidelines and test their effectiveness.