Materials and Methods for Recruiting Systematically Marginalized Youth and Families for Weight-Management Intervention Trials: Community Stakeholders' Perspectives.

Rates of overweight and obesity are problematic among systematically marginalized youth; however, these youth and their families are a hard-to-reach research population. The purpose of our study was to identify facilitators and barriers for recruiting systematically marginalized families in youth weight-management intervention research. This study built upon existing evidence through involvement of youth, parents, community agency workers, and school nurses, and an exploration of both recruitment materials and processes. Seven focus groups were conducted with 48 participants from 4 stakeholder groups (youth, parents, school nurses, and community agency workers). A codebook approach to thematic analysis was used to identify key facilitator and barrier themes related to recruitment materials and processes across the stakeholder groups. Ecological systems theory was applied to contextualize the facilitators and barriers identified. Participants reported the need to actively recruit youth in the study through engaging, fun recruitment materials and processes. Participants reported greater interest in recruitment at community-based events, as compared to recruitment through health care providers, underscoring the depth of distrust that this sample group has for the health care system. Recommendations for recruitment materials and processes for weight-management intervention research with systematically marginalized families are proposed.

Caring for the poor: Lessons learned from a simulation on social determinants of health.

Poverty is a dominant social determinant of health (SDOH). One in 10 people in the United States lives in poverty. During the pandemic unemployment increased exponentially, swelling the number of individuals and families with limited resources. Adverse health outcomes and challenges in accessing healthcare for the poor are well documented. This paper describes a simulation comprised of case study enactments to increase collaboration among future healthcare providers as they mitigate the negative impact of SDOH, with particular focus on poverty. University students from schools of nursing, public health, and medicine, joined by health care and social service providers from the community, engaged in problem solving through role playing enactments of case studies. Focus groups were conducted to explicate the process and capture challenges, triumphs, and problem solving strategies associated with SDOH, particularly poverty. Directed content analysis and thematic analysis were used to analyze the focus groups. Six themes emerged from simulation debriefings that provide critical lessons related to SDOH and caring for the poor: "When it Rains, it Pours," "Coming of Age Too Soon," Delay and Deny, "Time is Money," "When You Don't Know Your Options, You Don't Have Any," and "Walking in the Shoes of Others." Recommendations included using simulations, with focus groups as a primary methodological approach, for preparing and updating the skills of the present and future healthcare workforce in addressing SDOH especially as recovery from the pandemic takes place.

Culturally Anchoring an Intervention for Gender-Based Violence.

Haitians continue to rebuild following the devastating earthquake in 2010, as many also strive to recover and heal from associated horrific events. Immediately following the earthquake, domestic and international agencies reported dramatic increases in violence against women and girls in this small Caribbean nation that shares the island of Hispaniola with the Dominican Republic. In this article we highlight one segment of a situational analysis used as groundwork for developing an intervention to address gender-based violence (GBV). We sought to rapidly identify existing and needed resources and services for internally displaced women and girls in Haiti and to facilitate an immediate and sustainable response. During an eight-day period, we convened focus groups in Port au Prince. Displaced women and older girls, directors of nongovernmental organizations (NGOs), healthcare providers and administrators, and community youth leaders participated in the focus groups. Findings from these focus groups illuminate the multiple influences of GBV on displaced women and girls. Gaps, strengths, and limitations of existing resources, capacities, systems, and services for internally displaced Haitian women and girls were identified. In addition, factors that could potentially support or hinder effective implementation of preventive and response interventions were revealed. Our findings provided a foundation and structure for developing a culturally- specific educational and safety plan which was used in Haiti following the earthquake and continues to have relevance for use, today.

Transition-Aged Youths With Dual Diagnoses.

The current study provides an overview of the research knowledge about unique problems encountered by transition-aged youths with dual diagnoses. A description of the considerable physical and emotional changes experienced by transition-aged youths provides a foundation for exploring the pressures and challenges compounded by mental health issues and substance abuse. Programs that provide intensive support throughout the transition years pay valuable dividends. However, transition-aged youths with dual diagnoses of mental disorders and substance abuse find themselves faced with limited or nonexistent options. There is a confusing lack of continuity and consistency of supports and services, which complicates the already perplexing circumstances that beleaguer the lives of young adults with dual diagnoses.

The Transition to Independence Process: Promoting Self-Efficacy in Transition-Aged Youths.

Transition to adulthood is a developmental stage that presents unique and challenging problems. For individuals with dual diagnoses of mental disorders and substance abuse, the tragic dilemma confronting them is one of limited or nonexistent options as they attempt to navigate their way from child and adolescent services to adult programs. The Transition to Independence Process (TIP) is designed to facilitate more successful outcomes in the transition to adulthood by offering continuity of support. Nursing plays a crucial role in enabling young adults to develop a healthy sense of self-efficacy, thus facilitating the success of a TIP program. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 49-53.].

Strategies to Engage Systematically Marginalized Youth and Their Families in Research Using High-Tech Methods.

The purpose of this study was to identify facilitators and barriers for engaging youth and families from a historically and systematically marginalized community in high-tech research. Adapting community-based participatory research principles, 4 focus groups were conducted with 13 youth and 12 parents. Using codebook thematic analysis, 5 facilitator themes (develop skills, ensure health, build understanding, promote safety, and help others, youth-initiated interest) and 4 barrier themes (anxiety and fear, skepticism, confusion, and unfamiliar/unknown experience) were identified. Youth and parent responses informed proposed guidelines for recruiting and engaging families in research using high-tech methods, particularly those from historically and systematically marginalized communities.

African-American males' knowledge and attitudes toward genetic testing and willingness to participate in genetic testing: a pilot study.

This descriptive pilot study explored the knowledge and attitudes of African-American males toward genetic testing and their willingness to participate in genetic testing. A convenience sample of 104 African-American males, from 19 to 79 years of age, was recruited from a national fraternity meeting. Data were collected using four surveys: Demographic and Background Data, Perceived Knowledge of Genetic Testing, Attitudes Toward Genetic Testing, and Willingness to Participate in Genetic Testing. Perceived genetic knowledge was low with a mean score of 5.6; however, participants had a favorable attitude toward genetic testing. Findings from this study suggested that participants were willing to participate in genetic testing with a total score of 46.8. Significant correlations existed between perceived genetic knowledge and willingness to participate in genetic testing. Interventions to increase perceived genetic knowledge and educate the participant on who is conducting the test and how the test will be performed may be beneficial to increase participation in genetic testing.

Nursing student perceptions of community in online learning.

Nursing faculty need to understand the unique aspects of online learning environments and develop new pedagogies for teaching in the virtual classroom. The concept of community is important in online learning and a strong sense of community can enhance student engagement and improve learning outcomes in online courses. Student perceptions of community in online learning environments were explored in this study. Five focus group sessions were held and online nursing students were asked to give examples of experiences related to sense of community. Fifteen major themes emerged: class structure, required participation, teamwork, technology, becoming, commonalities, disconnects, mutual exchange, online etiquette, informal discussions, aloneness, trepidation, unknowns, nonverbal communication and anonymity. Themes sorted into the categories of structural, processual and emotional factors. Theme descriptions show how sense of community can be enhanced and/or diminished in online courses. This study adds depth and detail to the limited body of research on sense of community in distance education in nursing courses.

Components of a TIP Model Program.

Transition-aged youth in need of services and supports find themselves in a quandary; in certain instances, they are considered children, whereas in other circumstances, they qualify as adults. Transition to Independence Process (TIP) provides a promising model for transition-aged youth programs. It is distinguished by an emphasis upon client-driven goals, as opposed to agency-defined goals. Another key feature is reliance upon collaboration among service providers in order to address the myriad of needs of young adults. From the perspective of transition-aged clients, an efficacious TIP program must offer support services, including mental health care. It must encourage natural supports, including family. All of the facets of a TIP model program should have as their ultimate focus the education and employment of transition-aged youth. Together, these contribute to the best possible outcomes for transition-aged youth.

Use of Appreciative Inquiry To Engage Parents as Codesigners of a Weight Management Intervention for Adolescents.

BACKGROUND: Focus groups are often used to involve families as codesigners of weight management interventions. Focus groups, however, are seldom designed to elicit families' strengths and positive experiences. The purpose of this study was to describe the use of the Appreciative Inquiry process in the conduct of focus groups to engage families in the design of a weight management intervention for adolescents. METHODS: A convenience sample of 44 parents (84% female; 82% minority) of adolescent children with a BMI ≥ 85th percentile, who were in the 6th-8th grade in a large urban school, participated in focus groups designed to elicit family-positive experiences and strengths regarding healthy living. A structured set of questions based on the Appreciative Inquiry process was used in the focus groups. Analyses consisted of the constant comparative method to generate themes. RESULTS: Parent-positive perceptions regarding their family's healthy living habits were reflected in five themes: (1) Having healthy children is a joy; (2) Becoming healthy is a process; (3) Engaging in healthy habits is a family affair; (4) Good health habits can be achieved despite obstacles; and (5) School, community, and social factors contribute to their family's health habits. Parents generated ideas to improve their families' health. CONCLUSIONS: Focus groups based on the Appreciative Inquiry process were found to be a useful approach to discover features that are important to low-income, urban-living parents to include in an adolescent weight management program. Recommendations for designing and conducting focus groups based on the Appreciative Inquiry process are provided.

Strategies to Build Authorship Competence Among PhD Students.

Publication in refereed journals is an important responsibility of PhD-prepared nurses. Specialized writing skills are crucial for effective professional publication. The capacity to develop and publish articles is best learned during doctoral education. This Western Journal of Nursing Research Editorial Board Special Article addresses multi-dimensional strategies to develop authorship competence among doctoral students. The article outlines structured PhD program experiences to provide the context for students to develop authorship capacity. The authors identify multi-faceted faculty endeavors and student activities that are essential to foster authorship competence. Students who embrace opportunities to acquire authorship qualifications will be well prepared for their post-graduation role as stewards of the nursing discipline.

Normalizing Rejection.

Getting turned down for grant funding or having a manuscript rejected is an uncomfortable but not unusual occurrence during the course of a nurse researcher's professional life. Rejection can evoke an emotional response akin to the grieving process that can slow or even undermine productivity. Only by "normalizing" rejection, that is, by accepting it as an integral part of the scientific process, can researchers more quickly overcome negative emotions and instead use rejection to refine and advance their scientific programs. This article provides practical advice for coming to emotional terms with rejection and delineates methods for working constructively to address reviewer comments.

Evaluating nursing outcomes: a mixed-methods approach.

Being overweight is regarded as the most common nutritional disorder of children and adolescents in the United States. The escalating problem of being overweight or being obese in our society indicates the need for treatment strategies that encompass an all-inclusive approach. Moreover, these strategies need to be comprehensively evaluated for their effectiveness. Nurses are in an excellent position to ensure that this occurs. The purpose of this study was to determine whether using a mixed-methods approach was an efficacious way to provide a comprehensive evaluation of the behavior modification benefits of a weight loss/weight management nursing intervention in African-American adolescent girls (13-17 years of age). The overall effectiveness of the intervention was evaluated by analyzing pre- and post-program measures of weight, body mass index, cholesterol, blood pressure, self-esteem, depression, and body image (quantitative data); conducting focus groups with mothers of the participants; and administering open-ended, written questionnaires to the participants (qualitative data). Findings from the quantitative data indicated favorable outcomes in weight, blood pressure, cholesterol, body mass index, self-esteem, and body image, indicating that progress had been made over the course of the program. Furthermore, qualitative data indicated that mothers of the participants observed positive behavioral changes related to eating and exercise patterns and participants demonstrated perception of these changes as well.

Are Virtual Classrooms Colorblind?

E-learning, increasingly employed in nursing education, has been embraced as a means to enhance options for all students, particularly those with limited educational opportunities. Although a desire to increase access for underserved students is often cited, disparities in availability, usage, and quality of e-learning persist among diverse households and student populations when compared to the general population. In this article, these issues will be examined along with reflection on the extent to which culture has been integrated into on-line design and instruction. Historical and cultural aspects, circumscribing virtual classrooms, are discussed using African Americans as an exemplar. The imperative to harness the democratizing potential of this educational format is underscored. In this article, culture will be examined in light of the significant growth in on-line nursing education over the past several decades.