Mothers, Fathers, Sons, and Human Papillomavirus Immunization Practices.

Despite the fact that human papillomavirus (HPV) infection and HPV-related cancers are on the rise in men, male HPV vaccine series completion is less than 10% in many areas. This study examined parental knowledge of the HPV vaccine and intent to vaccinate their sons. A cross-sectional study of 341 parents of boys was conducted in school settings in rural southeastern Georgia. Mothers were 2.07 times more likely than fathers to vaccinate their sons. Future research directions should include strategies to increase HPV vaccination in both genders and focus on parents' perceived severity and vulnerability of their sons to HPV infection.

Examination of the Role of Religious and Psychosocial Factors in HIV Medication Adherence Rates.

Optimal adherence to antiretroviral therapy (ART) is associated with favorable HIV outcomes, including higher CD4 cell counts, HIV virus suppression and a lower risk of HIV transmission. However, only 25% of people living with HIV/AIDS (PLWH) in the USA are virally suppressed. Sub-optimal adherence (<90-95%) contributes to antiretroviral resistance and worse medical outcomes, including more rapid progression to AIDS and death. Psychosocial factors and religion/spirituality (R/S) have a significant impact on ART adherence, but the findings are mixed. The purpose of this study was to examine religious and psychosocial correlates and predictors of ≥90% ART adherence in PLWH. A cross-sectional study was conducted with a sample of 292 outpatient PLWH in the Southeastern USA. Participants completed computerized surveys. The mean ART adherence percentage was 80.9% and only about half reported ≥90% adherence. There were statistically significant differences in ART adherence rates based on age, depressive symptom status and frequency of religious attendance and prayer. Praying at least once a day was significantly associated with ≥90% ART adherence (OR = 2.26, 95% CI [1.06-4.79], p < 0.05). Social support satisfaction was also significantly associated with ART adherence (OR = 1.52, 95% CI [1.11-2.08], p < 0.05) and energy/fatigue/vitality (OR = 1.03, 95% CI [1.00-1.05], p < 0.05).

Initial evaluation of the Robert Wood Johnson Foundation Nurse Faculty Scholars program.

BACKGROUND: The Robert Wood Johnson Foundation Nurse Faculty Scholars (RWJF NFS) program was developed to enhance the career trajectory of young nursing faculty and to train the next generation of nurse scholars. Although there are publications that describe the RWJF NFS, no evaluative reports have been published. The purpose of this study was to evaluate the first three cohorts (n = 42 scholars) of the RWJF NFS program. METHODS: A descriptive research design was used. Data were derived from quarterly and annual reports, and a questionnaire (seven open-ended questions) was administered via Survey Monkey Inc. (Palo Alto, CA, USA). RESULTS: During their tenure, scholars had on average six to seven articles published, were teaching/mentoring at the graduate level (93%), and holding leadership positions at their academic institutions (100%). Eleven scholars (26%) achieved fellowship in the American Academy of Nursing, one of the highest nursing honors. The average ratings on a Likert scale of 1 (not at all supportive) to 10 (extremely supportive) of whether or not RWJF had helped scholars achieve their goals in teaching, service, research, and leadership were 7.7, 8.0, 9.4, and 9.5, respectively. The majority of scholars reported a positive, supportive relationship with their primary nursing and research mentors; although, several scholars noted challenges in connecting for meetings or telephone calls with their national nursing mentors. CONCLUSIONS: These initial results of the RWJF NFS program highlight the success of the program in meeting its overall goal-preparing the next generation of nursing academic scholars for leadership in the profession.

Overcoming the triad of rural health disparities: How local culture, lack of economic opportunity, and geographic location instigate health disparities.

OBJECTIVE: To discuss how the effects of culture, economy, and geographical location intersect to form a gestalt triad determining health-related disparities in rural areas. METHODS: We critically profile each component of the deterministic triad in shaping current health-related disparities in rural areas; evaluate the uniquely composed intersections of these disparities in relation to Human Papillomavirus (HPV)-related cancer prevention in three isolated rural Georgia counties; and develop implications for future leadership in rural healthcare research, policy, and practice. RESULTS: The deterministic triad of culture, economy, and geographical location is unique to a rural community, and even if two rural communities experience the same health disparity, each community is likely to have a discretely different composition of cultural, economic, and geographic determinants. CONCLUSION: The deterministic triad presents a challenge for health policymakers, researchers, and practitioners trying to develop health-related interventions that are equitable, efficacious, and practical in low-resource rural communities. The situation is worsened by the limited opportunities for employment, which leads to greater disparities and creates propagating cultural norms that further reduce access to healthcare and opportunities for sustainable health promotion.

Identifying effective vaccine champions: Findings from a national survey of primary care professionals.

BACKGROUND: Vaccine champions are common in primary care, but little is known about which champions are effective. METHODS: In 2022, we surveyed 2,144 US primary care professionals (PCPs) who reported working with vaccine champions. Respondents rated the champion with whom they worked most closely on their effectiveness at improving vaccination rates. RESULTS: About half (49 %) of PCPs perceived their closest champion as highly effective. PCPs perceived advanced practice providers and nursing staff as highly effective somewhat more often than physicians (52 % and 58 % vs 43 %, p <.001). Other correlates of perceived effectiveness included being a formally appointed versus informal champion, working extremely versus less closely with PCPs, and using a high (4-5) versus low (0-1) number of implementation strategies to improve vaccination rates (all p <.001). CONCLUSIONS: Results suggest vaccine champions may benefit from having formal roles and opportunities to work closely with colleagues to improve vaccination rates using multiple strategies.

Symptoms and risk factors associated with first urinary tract infection in college age women: a prospective cohort study.

PURPOSE: We identified epidemiological risk factors for the initial urinary tract infection in females of college age compared to age matched controls. MATERIALS AND METHODS: We performed a prospective cohort study from July 2001 to January 2006 at the student health care facility at our institution. A total of 180 women experiencing a first urinary tract infection were compared to 80 asymptomatic women with no urinary tract infection history who served as controls. Urinalysis and urine culture were done at study enrollment. Questionnaires were used to obtain information on clinical symptoms and behaviors, including sexual and dietary practices, and alcohol consumption. Logistic regression was performed to identify potential risk factors in women who presented with an initial urinary tract infection compared with controls. Principal component analysis was then done to identify key sexual activity variables for multiple regression models. RESULTS: Urinary frequency and urgency were the most common urinary tract infection symptoms. Recent sexual activity was a significant risk factor for urinary tract infection with vaginal intercourse (p = 0.002) and the number of sexual partners in the last 2 weeks (p <0.001) as the 2 primary variables. Alcohol consumption was associated with 2 of the 3 main principal components of sexual activity. Caffeinated beverage consumption also increased the risk of urinary tract infection (p <0.04). Escherichia coli was the predominant pathogen isolated, followed by urease positive microbes. CONCLUSIONS: Recent sexual activity, the frequency of that activity and the number of sexual partners pose an increased risk of urinary tract infection. Alcohol consumption frequency and amount correlated with these behaviors.

The Robert Wood Johnson Foundation Nurse Faculty Scholars Program: an opportunity for junior nurse faculty.

The Robert Wood Johnson Foundation Nurse Faculty Scholars program provides promising junior faculty extramural funding, expert mentoring, and the training needed to be successful in the academic role. The Nurse Faculty Scholars program, which admitted its first cohort in 2008, is designed to address the nursing faculty shortage by enhancing leadership, educational, and research skills in junior nursing faculty. This article provides an overview of the program, its purpose, and its eligibility requirements. The authors give strategies for selecting mentors, developing the written application, and preparing for an oral interview. Finally, the authors provide an analysis of funded institutions, research design and methods from current and recently funded projects, and rank and positions held by nursing mentors.

Cultural Values Influencing Immigrant Haitian Mothers' Attitudes Toward Human Papillomavirus Vaccination for Daughters.

Although research has shown that mothers significantly influence daughters' willingness to be vaccinated against the human papillomavirus (HPV), cultural factors influencing immigrant Haitian mothers' willingness to have adolescent daughters to be vaccinated are unknown. This is of concern as this population experiences disproportionately higher rates of HPV infection and related cervical cancers. This study identifies cultural beliefs influencing 31 immigrant Haitian mothers' willingness to vaccinate their daughters against HPV using semistructured interviews. Mothers had low levels of HPV and HPV vaccine knowledge, and desired more information. Concerns centered on cultural values regarding adolescent sexuality and HIV/AIDS stigmas specific to Haitian communities. If vaccination were recommended by a physician, mothers are more likely to have their daughters vaccinated. HPV vaccination uptake efforts targeting Haitian months should emphasize physician involvement and incorporate culturally relevant health concerns.

Parental Human Papillomavirus Vaccine Survey (PHPVS): nurse-led instrument development and psychometric testing for use in research and primary care screening.

BACKGROUND AND PURPOSE: Human papillomavirus (HPV) vaccine was approved for girls aged 9-24 years in 2006 to prevent HPV infection and cervical cancer. The Parental Human Papillomavirus Survey (PHPVS) was framed on theoretical constructs of the health belief model (HBM) and developed to survey parents regarding their HPV knowledge, attitudes, and intent to vaccinate. METHODS: We evaluated the psychometric properties of the PHPVS using classical item analysis and exploratory factor analysis (EFA) among a sample of 200 parents/caregivers. RESULTS: The EFA yielded a 4-factor unidimensional model that explained between 62% and 68% of the total variance depending on the extraction method used. The estimated Cronbach's alpha for the PHPVS was .96. CONCLUSIONS: The PHPVS is a reliable measure of HPV knowledge, attitudes, and intent to vaccinate.

Rural African American parents' knowledge and decisions about human papillomavirus vaccination.

PURPOSE: To identify predictors of human papillomavirus (HPV) vaccination among rural African American families. DESIGN: Cross-sectional descriptive study in schools in three rural counties in southeastern United States. The sample consisted of African American parents or caregivers with children 9 to 13 years of age who attended elementary or middle school in 2010-2011. METHODS: Using an anonymous, 26-item survey, we collected descriptive data during parent-teacher events from African American parents with children in elementary or middle school. The main outcome was measured as a response of "yes" to the statement "I have or will vaccinate my child with the HPV vaccine." In addition, composite scores of knowledge and positive attitudes and beliefs were compared. No interventions were conducted. FINDINGS: We identified predictors of HPV vaccination and found that religious affiliation had a correlation with vaccinating or planning to vaccinate a child. CONCLUSIONS: Results indicate a need for further research on the role of local culture, including religion and faith, in rural African Americans' decisions about giving their children the HPV vaccination. CLINICAL RELEVANCE: This study emphasizes the importance of understanding rural African American parents' knowledge, attitudes, and spiritual beliefs when designing health education programs and public health interventions to increase HPV vaccination uptake among African American boys and girls living in rural areas.

The Influence of Skin Color on Heterosexual Black College Women's Dating Beliefs.

Black women's skin color perceptions were identified utilized qualitative methods. The primary goal was to identify the relevance of these perceptions on their understandings about dating preferences and related beliefs about appropriate scripts using a Black feminist thought framework. Twenty- eight self- identified Black women attending a large university in the southeastern United States were interviewed for this study. Lighter- skin was perceived as being more attractive, and associated with four themes about dating: (a) positive personality traits, (b) increased value in dating contexts, and (c) sexual appeal to men. Therapeutic considerations for addressing skin color concerns with Black female clients, including addressing within group differences and validation of skin color values, are addressed.

Challenges and Collaborations: A Case Study for Successful Sexual Assault Nurse Examiner Education in Rural Communities During the COVID-19 Pandemic.

ABSTRACT: Challenges can often only be overcome with collaboration. In this case report of a Health Resources and Services Administration-funded program for Advancing Nurse Education - Sexual Assault Nurse Examiner, we describe the unique challenges and collaborations that have taken place in rural communities as we continued to train nurses during the COVID-19 pandemic. Geography and lack of availability of sexual assault nurse examiner (SANE) trainees brought many challenges as we prepared them to successfully pass the SANE certification examination and recruit new cohorts to expand SANE education.During the implementation of this program, we found that our process model, community collaboration, and commitment to these rural counties were the keys to our success before and during the COVID-19 pandemic.SANE trainee process and outcome measures were collected through quantitative and qualitative data collection. These data from the first cohort, along with the strategies implemented as all partners navigated the challenges of COVID-19, helped to strengthen our collaboration and expand the program. Details of these strategies and outcomes to date will be discussed.

Cardiac e-learning: Development of a web-based implantable cardioverter defibrillator educational system.

OBJECTIVE: The objective of this study was to design a Web-based implantable cardioverter defibrillator (ICD) module that would allow greater access to learning which could occur at an individual's convenience outside the fast-paced clinical environment. MATERIALS AND METHODS: A Web-based ICD software educational program was developed to provide general knowledge of the function of the ICD and the interpretation of the stored electrocardiograms. This learning tool could be accessed at any time via the Columbia University Internet server, using a unique, password protected login. A series of basic and advanced ICD terms were presented using actual ICD screenshots and videos that simulated scenarios the practitioner would most commonly encounter in the fast-paced clinical setting. To determine the usefulness of the site and improve the module, practitioners were asked to complete a brief (less than 5 min) online survey at the end of the module. RESULTS: Twenty-six practitioners have logged into our Web site: 20 nurses/nurse practitioners, four cardiac fellows, and two other practitioners. The majority of respondents rated the program as easy to use and useful. CONCLUSION: The success of this module has led to it becoming part of the training for student nurse practitioners before a clinical electrophysiology rotation, and the module is accessed by our cardiac entry level fellows before a rotation in the intensive care unit or electrophysiology service. Remote electronic arrhythmia learning is a successful example of the melding of technology and education to enhance clinical learning.

Project genesis: self-reported religiosity and spirituality and sexual risk-taking in young African-American women attending a historically African-American college.

This pilot study explored the relationship between self-reported religiosity, spirituality, and sexual risk-taking. The participants were a convenience sample of (N = 100) female students attending a historically African-American college (HBCU) in the south. On this predominantly female campus, students completed an anonymous health-risk survey, plus additional items, to measure their religiosity and spirituality. Correlation analysis revealed that although these students reported a high degree of religiosity and spirituality, these characteristics did not predict a decrease in sexual risk-taking behavior. Over six million new cases of sexually transmitted infections (STIs), including the human papilloma virus (HPV), are projected in young Americans despite primary prevention measures. Although no predictive relationships were noted, self-reported spirituality or religiosity were not protective factors against high-risk sexual behavior. These findings are relevant to developing effective interventions in this population in order to decrease STI/HPV rates.

Predicting incidence and asymptomatic rates for chlamydia in small domains.

AIM: This article is a report of a study of the use of predictive analysis using the Bayesian hierarchical model and small area estimation as an innovative methodology to address the challenges nurses face when managing fiscal and clinical resources in outpatient and inpatient settings. BACKGROUND: Nurses responsible for clinic management are confronted with the fiscal challenges in today's healthcare environment. Identifying those at risk for asymptomatic infections such as chlamydia and getting resources to that group has been a constant nursing care challenge for those in outpatient and inpatient clinics. METHODS: A secondary analysis of quantitative survey data was conducted in 2008, using predictive analysis with the Bayesian hierarchical model and small area estimation of statistics. DISCUSSION: The development of an innovative statistical procedure is an interesting and challenging opportunity. The opportunity to apply this innovative technique to an actual data set opens the possibility to replicating the technique and using it in other settings. If implemented and replicated, this innovative analysis can become a tool for managing limited fiscal and clinical resources. RESULTS: White, Hispanic and African American undergraduate students had slightly higher rates than the corresponding graduate students. The incidence rates were higher for White, Hispanic and African American undergraduate students than for graduate students. The incidence rates for African Americans were much higher than for the other identified racial groups, but very similar for graduate students and undergraduate students. CONCLUSION: Predictive analysis using the Bayesian hierarchal model and small area estimation can help nurses to project healthcare costs and services for underserved groups in healthcare clinics, with an improved empirical rationale.

A short report: parents HPV vaccine knowledge in rural South Florida.

An exploratory pilot descriptive research study was conducted in the rural counties of Hendry and Glades Florida exploring parental knowledge and hesitancy of HPV vaccination. Participants included parents/caregivers with children ages 9 to 13; using quantitative methods, we evaluated knowledge, feelings, and beliefs toward HPV vaccination including vaccination prevalence and correlates among participating parents/caregivers. Our measures included the Parental HPV Survey with a Cronbach's alpha of .96. Hesitancy-focused results revealed 26% of parents showed caution because of stigma around vaccination while attributing low levels of knowledge about HPV vaccination; 80% had a persistent belief HPV vaccination could leave their child sterile, perpetuating hesitancy. Participants with a high-school education or less (64%) and conservative religious affiliation, e.g., Baptist and Catholic (74%), did not decline HPV vaccination. Results are striking considering research indicating conservative religious views and lack of a college education leads to lower HPV vaccination rates. Numerous interventions to increase HPV vaccination have been studied including strong recommendations for increased provider communication but our data indicates increasing public education with community input and a focus on cultural norms in each specific rural community among parents and providers is needed to increase HPV vaccine knowledge and decrease HPV vaccine hesitancy.

The new human papillomavirus (HPV) vaccine: pros and cons for pediatric and adolescent health.

The new human papillomavirus (HPV) vaccine is a research breakthrough for pediatric/adolescent health to prevent cervical cancer and related morbidity. The annual heath care cost for the treatment of cervical cancer and genital warts is estimated to be more than three billion dollars a year. The new HPV vaccine has incredible potential to improve reproductive health promotion, reduce health care costs, and close health care disparity gaps. However, issues both for and against the new HPV vaccine, including mandating vaccination, high cost of the vaccine, the short duration of protection offered, and the perceived promotion of sexual activity, cause confusion. Pediatric nurses, including those in advanced practice, benefit by understanding the pros and cons of these issues in advocating for their patients.

A summative evaluation of productivity and accomplishments of Robert Wood Johnson Foundation Nurse Faculty Scholars Program participants.

From 2008 to 2017, the Robert Wood Johnson Foundation Nurse Faculty Scholars Program inspired, developed, and supported cohorts of next generation national leaders in academic nursing through career development awards. With support from mentors, scholars in the program created individual development plans focused on scholarship, teaching, service, and leadership. The curriculum of the scholar development program combined goals and objectives related to leadership development, enhancement of nursing education skills, and focused programs of research and scholarship. In addition, program outcomes emphasized engagement in institutional, university, and professional governance systems. This article describes and recounts findings from the program participants regarding accomplishments, productivity, and facilitators contributing to their achievement of program outcomes.

Sexual Risk Behaviors of African American Adolescent Females: The Role of Cognitive and Religious Factors.

INTRODUCTION: African American (AA) high school-age girls are more likely to have had sex before age 13 years and have higher rates of all sexually transmitted infections. Cognition and religion/spirituality are associated with adolescent sexuality, therefore, the purpose of this study was to identify cognitive and religious substrates of AA girls' risky sexual behaviors. METHOD: A descriptive study was conducted with 65 AA girls aged 15 to 20 years using computerized questionnaires and cognitive function tasks. RESULTS: Average age was 17.8 ± 1.9 years and average sexual initiation age was 15.5 ± 2.6 years. Overall, 57.6% reported a history of vaginal sex. Girls who reported low/moderate religious importance were significantly younger at vaginal sex initiation than girls for whom religion was very/extremely important. Girls who attended church infrequently reported significantly more sexual partners. IMPLICATIONS: Health care providers can use these findings to deliver culturally congruent health care by assessing and addressing these psychosocial factors in this population.

Cancer Prevention: HPV Vaccination.

OBJECTIVES: To provide an overview of human papillomavirus (HPV) vaccination as cancer prevention with current strategies that nurses can use to help patients and parents overcome barriers to HPV vaccination. DATA SOURCES: Peer-reviewed literature, presentation abstracts, and current immunization recommendations from the Advisory Council on Immunization Practice. CONCLUSION: Nurses can help prevent cancer by encouraging HPV vaccination during routine immunization and make HPV vaccination normal and routine. IMPLICATIONS FOR NURSING PRACTICE: A vaccine to reduce/eliminate HPV-related cancers enables nurses' at all educational levels to advocate for cancer prevention through initiation and completion of the HPV vaccine series.