Knowledge, attitudes, and beliefs of cardiovascular disease prevention in young adults in the country of Georgia.

INTRODUCTION: Cardiovascular disease (CVD) accounts for 46% of all mortality in the country of Georgia (former Soviet Union). Young adults in that country have not been studied regarding CVD and a need exists to understand lifestyle modifications to promote cardiovascular health. DESIGN: An interpretive description qualitative design was used to explore Georgian young adults' knowledge, attitudes, and beliefs of CVD preventative practices and life experiences. METHODS: A convenience sample of 19 ethnic Georgian participants (18-40 years old) who were fluent in either English, Georgian, or Russian from a local private university was used. Semi-structured interviews were conducted via video conferencing utilizing an interpreter. RESULTS: Four themes were identified: (1) CVD and risk factor knowledge, (2) prevention attitudes, beliefs, and gender differences, (3) health literacy influences, and (4) culture and societal impacts. CVD knowledge was limited and influenced by health literacy and the current healthcare system in Georgia. CONCLUSION: Cultural and societal gender norms influence cardiovascular health behaviors. CLINICAL IMPLICATIONS: Georgian nurses can play a key role in CVD education and screening for young adults in Georgia.

Implementation of an educational program for nursing students amidst the Ebola virus disease epidemic.

BACKGROUND: The global Ebola virus disease (EVD) epidemic of 2014/2015 prompted faculty at Emory University to develop an educational program for nursing students to increase EVD knowledge and confidence and decrease concerns about exposure risk. PURPOSE: The purpose of this article is to describe the development, implementation, and evaluation of the EVD Just-in-Time Teaching (JiTT) educational program. METHODS: Informational sessions, online course links, and a targeted, self-directed slide presentation were developed and implemented for the EVD educational program. Three student surveys administered at different time points were used to evaluate the program and change in students' EVD knowledge, confidence in knowledge, and risk concern. DISCUSSION: Implementation of a JiTT educational program effectively achieved our goals to increase EVD knowledge, decrease fear, and enhance student confidence in the ability to discuss EVD risk. These achievements were sustained over time. CONCLUSION: JiTT methodology is an effective strategy for schools of nursing to respond quickly and comprehensively during an unanticipated infectious disease outbreak.

Providing 360-degree multisource feedback to nurse educators in the country of Georgia: a formative evaluation of acceptability.

BACKGROUND: Due to insufficient nursing education standards in the country of Georgia, 15 health professionals participated in a USAID grant-funded nurse educator faculty development program. These educators then offered continuing education courses and taught more than 1,700 practicing Georgian nurses over 3 years. METHOD: Using a 360-degree multisource feedback model (MSF), self, video, learner, peer, and program coordinator evaluations of teaching effectiveness were completed. After nurse educators reviewed their results and identified areas for improvement, a questionnaire about the perceived acceptability of teacher evaluations was completed. RESULTS: Of the 15 nurse educators, 93.3% indicated that nurse educators should receive feedback through self, learner, peer, and video evaluations, and 100% indicated that nurse educators should receive feedback from the program coordinator. The accuracy and usefulness of the program coordinator evaluation was rated the highest, whereas peer evaluation was rated the lowest. CONCLUSION: This study revealed that MSF was acceptable to Georgian nurse educators.

Health status of children of migrant farm workers: Farm Worker Family Health Program, Moultrie, Georgia.

OBJECTIVES: We evaluated the health status of migrant farmworkers' children served by the Farm Worker Family Health Program (FWFHP) in Moultrie, Georgia. METHODS: We analyzed data from children aged 0 to 16 years examined through the FWFHP from 2003 to 2011 (n across years = 179-415). We compared their prevalence of overweight, obesity, elevated blood pressure, anemia, and stunting with that of children in the United States and Mexico. RESULTS: Across study years, prevalence of overweight, obesity, elevated blood pressure, anemia, and stunting ranged from 13.5% to 21.8%, 24.0% to 37.4%, 4.1% to 20.2%, 10.1% to 23.9%, and 1% to 6.4%, respectively. Children in the FWFHP had a higher prevalence of obesity than children in all comparison groups, and FWFHP children aged 6 to 12 years had a higher prevalence of elevated blood pressure than all comparison groups. Older FWFHP children had a higher prevalence of anemia than US children and Mexican children. Children in FWFHP had a higher prevalence of stunting than US and Mexican American children. CONCLUSIONS: We observed an elevated prevalence of obesity, anemia among older age groups, and stunting in this sample of children of migrant workers.

Preparing nurse educators in the country of Georgia.

This article describes a formal nurse educator train-the-trainer program initiated to educate qualified health professionals to teach contemporary nursing continuing education in the country of Georgia, formerly part of the Soviet Union. A 3-month intensive train-the-trainer program model was used to educate potential nurse educators to provide a foundation for introducing a higher level of continuing education to practicing nurses in Georgia. After the potential nurse educator candidates were interviewed and hired, they were required to attend at least 90% of the classes, achieve a score of 85% or higher on all train-the-trainer class posttests, and achieve a score of 90% or higher on the final examination. Sixteen of 17 nurse educators, who were physicians and nurses, successfully completed the program. These graduate nurse educators subsequently conducted formal continuing education for more than 2,900 practicing nurses, with a goal of implementing a baccalaureate nursing program as well. This program established a foundation for further nurse educator development and improvement in continuing education for currently practicing nurses in the country of Georgia.

The impact of invisibility on the health of migrant farmworkers in the southeastern United States: a case study from georgia.

Migrant farmworkers represent one of the most marginalized and underserved populations in the United States. Acculturation theory cannot be easily mapped onto the transnational experience of migrant farmworkers, who navigate multiple physical and cultural spaces yearly, and who are not recognized by the state they constitute, "the Citizen's Other" (Kerber, 2009). This paper utilizes narrative analysis of a case study to illustrate, through the relationship of the narrator to migrant farmworkers and years of participant observation by the coauthors, how isolation from family and community, as well as invisibility within institutions, affect the health and well-being of migrant farmworkers in southeastern Georgia. Invisibility of farmworkers within institutions, such as health care, the educational system, social services, domestic violence shelters, and churches contribute to illness among farmworkers. The dominant American discourse surrounding immigration policy addresses the strain immigrants put on the social systems, educational system, and the health care system. Nurses who work with farmworkers are well positioned to bring the subjective experience of farmworkers to light, especially for those engaged with socially just policies. Those who contribute to the abundant agricultural produce that feeds Americans deserve the recognition upon which social integration depends.

The health of female child care providers: implications for quality of care.

The purpose of this investigation was to determine the health behaviors and perceived health status of child care providers. Health behaviors and health status were also examined in relation to caring for children and the providers' perceptions of quality child care. A researcher-developed questionnaire, adapted from Williams, Mason, and Wold (2001), was mailed to a random sample of 1,000 child care providers employed in 49 child care centers in Georgia. Results indicated that, overall, the sample was a healthy population with 86.8% rating their health as good to excellent. Seventy-three percent (73%) received a physical exam annually, and 70% reported having health insurance. Despite these ratings, participants reported that they were overweight, were emotionally strained, and did not engage in physical exercise at least 3 times per week. Although most performed breast self-exams, the majority did not fully understand breast health practices. Furthermore, the majority of the child care providers (78.7%) believed that their health does not impact the care that they provide to children. Last, their definitions of quality of care for children suggested a minimal standard of care or less. These findings provide information that can be useful in designing occupational health programs within community child care settings and in promoting healthy behaviors in women.

Use of public health nurse competencies to develop a childcare health consultant workforce.

UNLABELLED: The purpose of this article is to describe the efforts in the state of Georgia to train public health nurse-childcare health consultants (PHN-CCHCs) using the framework of the "Core competencies for public health practice." OBJECTIVES: The goal of the training was twofold: (1) to prepare a statewide cadre of PHNs as the primary workforce for Georgia's emerging childcare health consultation (CCHC) system and (2) to prepare their district nurse directors to lead and support CCHCs. DESIGN: Administrators attended a 2-day workshop followed by access to executive coaching for their management teams. PHNs participated in a three-phase training program, with phases 1 and 3 offered as 3-day workshops with field experiences, and phase 2 offered online and as a practicum. SAMPLE: Forty-four administrators and over 85 PHN-CCHCs completed the training. RESULTS: Graduates of the program reported satisfaction with training and reported the use of PHN core competencies in CCHC. Graduates also found enhanced skills in using core competencies to be applicable to a variety of population-based practices. Beyond CCHC being instituted in selected health districts, interest in CCHC has occurred statewide. CONCLUSIONS: The PHN-CCHC program enhanced the knowledge and use of core competencies and heightened interest in CCHC statewide.

Assessing the need for child-care health consultants.

This study surveyed health and safety needs of child-care programs; examined the perceptions of directors, the person identified as being responsible for a program, concerning health consultation; and determined how directors would secure funds to pay for consultative services. The survey was conducted in a state without mandates for child-care health consultation and minimal access to consultants. The researchers designed and pilot-tested a Child Care Health and Safety Survey. Working with a task group of statewide child health experts, the researchers revised the survey and mailed it to a random sample of child-care programs. Twenty-two Head Start Programs, 122 licensed child-care centers, and 116 family child-care homes participated, representing a return rate of 73, 36, and 30%, respectively. The majority of programs expressed interest in child-care health consultation offered for free or fee-based. Directors identified reasonable means of obtaining funds to support consultation. All programs had needs related to supporting health practices in their settings, provision of health services for staff, and health screening for children. Public health nurses, specially trained to advise child care, are well positioned to offer consultation. Systems of health consultation may be accepted as fee-for-service arrangements, supporting sustainability.

Teaching the public health core competency of policy development to baccalaureate student nurses.

Teaching the public health core competency of policy development to baccalaureate student nurses was the purpose of this project. This project was implemented through interdisciplinary collaboration of one innovative state health district and the faculty of a large, urban university. Through education in the core competency of policy development, attention to one county's assessed health needs was introduced to its county board of health with the goal of influencing health policy regarding those needs. Data obtained have continued to be used by this county in health planning and grant writing activities and have been built upon by other student groups.

Partnership to build sustainable public health nurse child care health support.

Child care health consultation, an emerging health care delivery system aimed at improving the health and well-being of children enrolled in child care settings, is consistent with the public health core function of assurance. Public health nurses are the primary workforce for such consultation. Few states have critical masses of consultants, and many are struggling to financially support such programs. Through an academic-community partnership, Georgia's public health nurses are building a consultative system of child care health support. This partnership focuses on adding value in child care while strategically and financially supporting the sustainability of this population-focused practice.

CVD prevention strategies with urban and rural African American women.

Using Pender's Health Promotion Model, this study tested a work site cardiovascular disease (CVD) risk factor reduction intervention among low-income African American (LAAW) women. Individual CVD risk profiles were identified at the work site through (1) health risk appraisal, (2) blood pressure measurement, (3) body mass index calculation, (4) individual interviews about diet and exercise behaviors, and (5) total cholesterol analysis. Two LAAW groups, one urban and one rural, exhibited higher or similar pretest CVD relative risks (RR) when statistically compared with a national sample of African American women. The LAAW study samples were younger and more educated. Pretest cholesterol and fat intake for the rural women were higher than for the urban women (<.05). Posttest changes in cholesterol and fat intake risks were more significant in rural LAAW than in urban LAAW (<.05).