Systematic Review of Barriers to and Facilitators of Screening for Postpartum Depression at Well-Child Visits in the United States.

OBJECTIVE: To identify and evaluate barriers to and facilitators of screening for postpartum depression (PPD) during well-child visits in the United States. Additionally, to describe prior work on PPD screening tool evaluation and outcomes from PPD screenings conducted within the well-child setting. DATA SOURCES: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Five databases (Pub Med, PsycINFO, Web of Science, CINAHL, and Cochrane Library) were searched. STUDY SELECTION: Randomized controlled trials, case studies, cross-sectional studies, case-control studies, cohort studies, qualitative studies, and quasi-experimental studies conducted in the United States were included. The Standard Quality Assessment Criteria Tool (QualSyst) was used to assess the methodologic quality of each included study. DATA EXTRACTION: Sample, setting, methods, screening tools used, location of study setting, intervention, and salient findings were extracted and summarized for further analysis and synthesis. DATA SYNTHESIS: Quantitative studies were rated on 14 aspects, and qualitative studies were rated on 10 aspects, per QualSyst. Studies received a score of 2, 1, 0, or not applicable based on scoring criteria, with higher scores indicating greater methodologic quality. CONCLUSION: We found that barriers to PPD screening included concerns regarding time for screening, adequate training, and limited ability for referral. Facilitators of PPD screening included electronic prompts for providers, as well as tool availability and familiarity. Our results indicate that education and training about PPD screening in the pediatric setting are important next steps in addressing the rising concern of PPD in the United States.

The Teddy Bear Clinic: Engaging School-Aged Children in Health Education.

This article describes the use of play therapy in a school-based health clinic on an American Indian Reservation. The project used the play therapy model, a nursing intervention focused on using play materials in a therapeutic manner as a form of communication and self-expression for children, enhancing the development of social, emotional, and behavioral skills through the nursing process. The purpose of the Teddy Bear Clinic was to establish relationships among non-Native student nurses and Native American children and their community on a Northern Plains Indian Reservation. A discussion of the potential benefits addresses opportunities for school nurses and student nurses to enhance their understanding of children's perceptions of the health care clinic and the effects of historical trauma on the health and wellbeing of Native American children while offering an opportunity for young children to engage in the health care setting in a fun way, without fear or discomfort is provided.

Engaging Members of a Northern Plains Indian Reservation to Promote Community Responsive Health Care.

This article describes a project to engage community members and to determine how a school nurse-community partnership could improve healthcare equity within an American Indian community. The purpose of this community-building project was to establish a relationship among school nurse practitioners, children, and their community in a Northern Plains Indian reservation using a Community-Based Participatory Research (CBPR) model. CBPR requires a partnership between community members and school nurses in prioritizing community needs, developing an appropriate intervention, and engaging the community throughout the intervention project process. Partnering with teachers and the community, we engaged 78 students in a year-long project in which children depicted their perceptions of well-being and wellness through bimonthly art activities. This project laid the groundwork for a strong community partnership with school nurses in addressing the well-being of children and the further exploration of community needs.

Implementation of a COVID-19 Mass Vaccination Clinic to College Students in Montana.

We describe a large-scale collaborative intervention of practice measures and COVID-19 vaccine administration to college students in the priority 1b group, which included Black or Indigenous persons and other persons of color. In February 2021, at this decentralized vaccine distribution site at Montana State University in Bozeman, we administered 806 first doses and 776 second doses by implementing an interprofessional effort with personnel from relevant university units, including facilities management, student health, communications, administration, and academic units (e.g., nursing, medicine, medical assistant program, and engineering). (Am J Public Health. Published online ahead of print September 9, 2021:1776-1779. https://doi.org/10.2105/AJPH.2021.306435).

The impact of cultural immersion service learning on BSN graduates: A quasi-experimental evaluation.

AIM/OBJECTIVE: The cultural immersion service-learning model evaluated in this study sought to facilitate cultural consciousness of culturally congruent nursing care among predominantly White nursing students attending a university that was racially and culturally homogeneous. BACKGROUND: Evidence supports the use of cultural immersion service learning during undergraduate nursing programs in developing the skills necessary for effective transcultural healthcare; yet, little is known about its impact beyond the semester of the experience. DESIGN: This project used a quasi-experimental design to determine if transcultural self-efficacy of BSN graduates among five campuses differed. METHODS: One campus of the five conducted a mandatory cultural immersion service-learning experience during the graduates' junior year. From a population of 94 BSN graduates of which 30 (32%) graduates participated in the cultural immersion service-learning experience, 53 completed the Transcultural Self-Efficacy Tool. Eighteen (34%) of the graduates who participated in the cultural immersion service-learning experience participated in this study. RESULTS: The transcultural self-efficacy was significantly greater in those graduates who participated in the cultural immersion service-learning experience; yet, no difference was found among graduates of the four campuses not offering the experience. CONCLUSIONS: The cultural immersion service-learning experience seems to provide nursing students from racially and ethnically homogeneous communities with an experiential learning context which facilitates the development of transcultural self-efficacy.

Developing a Cultural Immersion Service-Learning Experience for Undergraduate Nursing Students.

BACKGROUND: Cultural consciousness is a central element of purposeful and appropriate health care delivery. Research suggests that cultural consciousness is strengthened through self-reflection, dialogue about race, and experience within other cultures. METHOD: Two cohorts of senior-level nursing students participated in a 1-week cultural immersion service-learning (CISL) experience in an isolated, rural American Indian community. Student reflections and White Racial Identity Attitude Scale (WRIAS) data were collected and analyzed. RESULTS: The CISL experience facilitated culturally conscious care in two thirds of the participating nursing students. Differences in WRIAS scores were statistically significant (p < .0001) with an effect size of 1.9. CONCLUSION: Implementing CISL experiences into the undergraduate curriculum may help nursing students recognize societal privilege and improve cultural consciousness. Recommendations are provided to assist nurse educators to develop partnerships with indigenous nations, which make CISL experiences possible. [J Nurs Educ. 2019;58(2):117-120.].

Engaging Nursing Students in a Rural Native American Community to Facilitate Cultural Consciousness.

Integrating cultural consciousness into nursing curricula is important for preparing a global nursing workforce. This article evaluated the impact of a teaching strategy designed to facilitate nursing students' cultural consciousness beyond the classroom during a 1-week field experience within a rurally isolated Native American community. Cultural consciousness health care is a central element of health care delivery that integrates clinical knowledge, sensitivity, and cultural understanding. This study used an intrinsic single case study design bounded by 30 nursing students' perceptions of their week-long immersion experience within a rurally isolated American Indian community. The reality of the situations they encountered did not match their expressed expectations nor their tacit assumptions. Evidence taken in situ from clinical reflections demonstrated most of the students wrestled with this mismatch, although they improved their clinical assessment, technical nursing, and intercultural communication skills. Evidence from end of course reflections demonstrated that two-thirds of the students integrated their preconceptions and their immersion experiences with cultural consciousness emerging in their reflections.