Survey of Southern Wisconsin Needle Exchange Clients Regarding Opioid Overdose and Naloxone Use.

BACKGROUND: Factors surrounding opioid overdose and naloxone use must be explored from the user perspective in order to more effectively combat the current opioid crisis. METHODS: AIDS Resource Center of Wisconsin needle exchange clients were surveyed regarding overdose victim demographics, interventions, experience with naloxone, and overdose outcomes. RESULTS: Most respondents (102/108, 94.4%) reported either experiencing or witnessing an overdose. While naloxone was often used (64/102, 62.7%), other recommended interventions, such as calling 911 (44/102, 43.1%) and rescue breathing (31/102, 30.4%) often were not. Potential legal consequences were cited as a major barrier for contacting emergency medical services (42.3%). DISCUSSION/CONCLUSION: There appears to be a need for education and/or policy change to facilitate appropriate overdose prevention and use of emergency medical services in the setting of opioid overdose.

An integrative model of adolescent health risk behavior.

Nursing research in adolescent health risk behavior is lacking because there are few comprehensive nursing models to guide it. Nurses need to understand what influences adolescents to engage in health risk behavior or to refrain from it. The Integrative Model of Adolescent Health Risk Behavior was developed to guide adolescent nursing research using existing theoretical and empirical data. Components include protective/escalatory factors, risk stimulus, maturity of judgment (as a meditational influence), and the risk decision (dichotomized into risk avoidance and taking). The model will facilitate development of nursing interventions to increase health protection by discouraging adolescents from making unhealthy choices.

Using a writing group to promote faculty scholarship.

Writing productivity is an essential component of scholarship. Barriers to writing include intrapersonal characteristics, faculty role complexity, and time constraints. Writing groups can increase faculty members' writing, contributing to dissemination of nursing knowledge and advancement of professional nursing. The authors discuss the structure and processes of a writing group that can be adapted by faculty interested in using comentoring to increase their scholarship.

Health effects of life transitions for women and children: a research model for public and community health nursing.

Because maternal-child populations have traditionally been a major practice target for public and community health nursing (P/CHN), understanding the health effects of life transition experiences for women and their children is key to the advancement of P/CHN practice and research. To date there are no integrated conceptual models available that examine transition and its health effects in women, and ultimately their children, to single or multiple transitions. In order to help women and those with dependent children transition successfully, strong transition frameworks for nursing are needed. The purpose of this paper is to describe a conceptual model, Health Effects of Life Transition for Women and Children. Major components include the transition experience (developmental, situational, health illness), transition assets/risks (personal, environmental), cognitive-behavioral health indicators of transition (perception of situation, personal efficacy, change readiness, engagement, help-seeking, health behaviors, services use), transition adaptive outcomes of health (health status, intensity of need for nursing care) and competence (transition specific skill acquisition, health management, resourcefulness) and long-term preventive health outcomes (risk reduction, disability prevention, cost savings, mastery, injury prevention). The authors propose that cognitive-behavioral health indicators are foundational to a successful transition experience, are why some people have better transition outcomes than others, and when influenced by P/CHN intervention lead to improved long-term outcomes.

Recruiting and enrolling pregnant adolescents for research.

Difficulty obtaining a sample is not justification for failure to study a hard-to-enroll population, particularly a vulnerable population such as pregnant adolescents. Recruitment of a representative, adequate sample of pregnant adolescents for a recent instrument development study provided multiple challenges. Although carefully developed, the sampling plan required several modifications to achieve the sample (n=145). Those challenges and the ensuing modifications to the sampling plan are discussed in relation to (a) access/institutional concerns, (b) the human subject's protection considerations, and (c) developmental/personal concerns of the pregnant adolescents. Recommendations for sampling strategies for future research are offered.

Health-risk behaviors in a sample of first-time pregnant adolescents.

OBJECTIVE: The purpose of this study was to assess the frequency of prenatal health-risk behaviors (substance use, sexual risk taking, and prenatal class attendance) among a nonrandom sample of first-time pregnant adolescents. DESIGN: The design is descriptive. SAMPLE: 145 ethnically diverse first-time pregnant adolescents aged 15-18 years. MEASUREMENT: Health behavior questions modified from the Center for Disease Control's Youth Risk Behavior Surveillance System. RESULTS: The health-risk behavior most modified during pregnancy was alcohol use (64/145 drank but quit and 1/145 did not quit). Of the 52/145 who used street drugs, nine continued despite pregnancy. Of the 75/145 who smoked early in pregnancy, 39 continued. The majority did not use a condom at last sexual intercourse. Approximately half attended a prenatal class and half attended a teen parenting class. CONCLUSION: Health-risk behaviors captured by birth certificate data are thought to be underreported for all age groups, and the prevalence of health-risk behaviors in this sample of pregnant teens was often greater than the most recent national trend data available. The magnitude of the effects of health-risk behaviors on pregnancy outcomes necessitates improved data gathering to enhance planning and evaluation of research and interventions at community, system, and individual/family levels.

The Adolescent Prenatal Questionnaire: assessing psychosocial factors that influence transition to motherhood.

The purpose of the study was to develop a psychometrically reliable and valid instrument that assesses psychosocial factors that influence transition to motherhood in first-time pregnant adolescents 15-18 years of age. The descriptive, correlational study tested the Adolescent Prenatal Questionnaire (APQ) in 145 unmarried first-time pregnant adolescents 15-18 years of age who planned to keep their infants. Factor analysis yielded an interpretable four-factor solution that accounted for 40% of the variance with adequate internal consistency estimates and test-retest correlations to merit further testing.

Using focus groups to evaluate and strengthen public health nursing population-focused interventions.

Nebraska Health Connection Access Medicaid's (NHC AM) public health nursing (PHN) population-focused practice model is designed to provide enrollment, education, and PHN case management interventions for the Medicaid Managed Care population. Evaluation and continuous improvement of these interventions are, in part, completed through a collaborative effort between NHC AM and a quality management team at the University of Nebraska Medical Center College of Nursing. Focus group methodology was used to access non-English-speaking populations to evaluate and strengthen population-focused PHN interventions.