Lessons learned from conducting a community-based, nurse-led HIV prevention trial with youth experiencing homelessness: Pivots and pitfalls.

OBJECTIVE: This article highlights key lessons learned while conducting a nurse-led community-based HIV prevention trial with youth experiencing homelessness (YEH), focusing on sexually transmitted infections testing and treatment, intervention sessions, community partnerships, and participant recruitment and retention. DESIGN: The insights and experiences shared aim to inform future research and the design of interventions targeting populations at high risk, particularly when facing unanticipated challenges. By addressing these areas, the article contributes to the decision-making for the design and delivery of effective strategies to improve the health outcomes among marginalized populations. RESULTS: The findings underscore the importance of flexibility and active participant engagement, cultivating strong relationships with community partners, utilizing technology and social media, and fostering a diverse research team that represents the heterogeneity of youth experiencing homelessness across race/ethnicity, gender identity, sexual orientation, and lived experiences. CONCLUSIONS: These recommendations aim to enhance participant access, engagement, and retention, while promoting rigorous research and meaningful study outcomes for YEH.

Broadcast health: Leveraging YouTube for community health education.

OBJECTIVE: In community health, there is great demand but limited time for the delivery of staff and patient education. During the COVID-19 pandemic, evolving needs necessitated that health education be provided in an accurate and timely manner. This paper describes the development, implementation, and evaluation of a YouTube channel designed to disseminate health education to a wide audience of public health workers and patient populations. METHODS: This project, divided into three phases, originated within shelter-based care, providing education to shelter staff (Phase 1) and overtime has evolved to provide education within the Community Health Worker Hub at a major teaching hospital for community health workers (Phase 2) and the populations they serve (Phase 3). Further, during phase 3, the project developer used an artificial intelligence (AI) platform to increase the reach of the YouTube channel. RESULTS: Over a span of 21 months, 18 unique videos have garnered 489 views. CONCLUSIONS: Clinicians and educators can leverage technology platforms for health education delivery, increasing the reach of their work while meeting the demands of the profession. While the quality of some information on YouTube may be poor, patients and students turn to this platform for health education. It is imperative that public health nurses embrace this medium, rather than push against it. By creating high-quality content, educating students and patients about DISCERN and PEMAT tools, and guiding patients to credible sources, public health nurses may ameliorate the standards of health education on YouTube.

Bringing COVID-19 vaccine to medically underserved populations utilizing a community-guided mobile vaccine program.

Between March 23, 2021, and December 31, 2022, the Mobile Vaccine Program (MVP) vaccinated 5044 individuals from medically-underserved communities in Middle Tennessee identified through and guided by a collaboration of local community agencies. The primary objective of the MVP was to vaccinate individuals for COVID-19 who had barriers to traditional mass vaccine strategies through community-guided strategies and partnerships. Three strategies were developed and implemented with community partners and their affiliated community health workers (CHWs). The strategies included pop-up vaccination clinics at community partner events, CHW-guided door-to-door in-home vaccination, and community partner-initiated homebound referrals for vaccination.

Implementation of nursing services in community corrections: A community-academic partnership.

Persons who are incarcerated (PWAI) suffer from a disproportionately higher number of physical and mental health conditions. While most jails and prisons provide onsite healthcare, community correctional centers often do not and accessing community healthcare is challenging due to insurance issues, inadequate health literacy, mistrust, and long waits for appointments. A registered nurse-led wellness clinic provides a viable solution to addressing the healthcare needs of PWAI in a community correctional setting. Through a community-academic partnership between a college of nursing and two community correctional transitional centers for men, a registered nurse (RN) faculty member and nursing students provide onsite healthcare. Services include, but are not limited to, acute and chronic disease management, case management, healthcare navigation, and health education. In the first 2 years of operation, there have been 587 new resident health assessments, 882 RN visits, and 152 group education sessions. RN visits have been primarily for: connection to resources (42.6%), medication management (15.6%), and acute conditions (12%). A RN-led wellness clinic is an innovative way to address health needs for PWAI. While this model of care focuses on an academic RN faculty practice at community correctional centers it could be replicated across community settings.

A Florida public health-based endocrine clinic for low-income pregnant women with diabetes.

OBJECTIVES: To evaluate pregnancy outcomes of low-income women with diabetes-complicated pregnancies who received care from an embedded, public health-based endocrine specialty clinic (ESC) in Florida. DESIGN: This program evaluation used retrospective chart data to analyze client characteristics, pre-program and during-program glycemic control, and pregnancy outcomes of women enrolled in a prenatal ESC. SAMPLE: Ninety-two low-income, pregnant women with type 1/type 2 diabetes or gestational diabetes (GDM) comprised this racially/ethnically diverse sample. VARIABLES/ANALYSIS: Neonatal outcomes included frequencies of prematurity, hypoglycemia, hyperbilirubinemia, and birth weight-for-gestational-age categories. Differences in maternal HbA1C at program entry and mean HbA1C during ESC care were determined by a Wilcoxon and paired sample t test. RESULTS: HbA1C levels during ESC care (6.9 ± 1.4) were less than program entry HbA1C levels (7.9 ± 1.8) for women with pregestational diabetes (Z = -3.364, p = .001). Among women with GDM, mean HbA1C values during ESC care (5.5 ± 0.4) did not significantly differ (t(51) = -0.532, p > .05) from program entry HbA1C levels (5.5 ± 0.5), suggestive of glycemic goal achievement. No neonatal hypoglycemia or hyperbilirubinemia cases were observed in both groups. Approximately 11% of births were preterm, and 16% of neonates were large-for-gestational-age. CONCLUSIONS: A public health-based ESC for low-income pregnant women with diabetes may positively affect pregnancy outcomes.

Nursing curriculum through a social justice lens: An upstream approach.

This article describes a one-day seminar rooted in critical interactionism for nursing students in a diverse urban setting in the United States. The authors are registered nurses and members of Nurses for Social Justice (NSJ)-a loose network of nurses and nursing students committed to societal change. Informed by the history of NSJ and larger social justice movements, the authors intentionally incorporate their personal experiences and offer an example of how nursing education can improve health at the micro and macro levels. The seminar starts with introductions and creating a safe space for authentic engagement. Students are guided to connect with their own journey to nursing and the experiences that have shaped their identities, including being oppressed and privileged. The lack of diversity within the nursing workforce and various nursing roles along the continuum of care are discussed. Case-based scenarios are presented where students explore leveraging their power and privilege to effectively partner with individuals and communities. In closing, lessons learned are shared through a group activity that uses the ecologic model. Recommendations are made to equip nursing students with tools to better understand their role in the broader context of health.

Improving the curriculum for a community nursing training program in Guangzhou City, China.

In China, community nurses do not have systematic training, and the nursing education curriculum focuses on clinical nursing both in vocational school and high school. Most nurses work at a hospital, and almost all community nurses lack systematic knowledge about community nursing. A training program for community nurses in Guangzhou City has been conducted since 2003. The training curriculum has evolved over the years, but is not standardized. This article describes research on improving community nurses' basic knowledge and practice skills. We modified the curriculum with a questionnaire and a modified Delphi method. First, 318 participating nurses and instructors were queried in December 2012. Then 22 experts modified the training program based on the results of the questionnaire and implementation since 2013. After 4 years, we followed up with the new participating nurses to evaluate the curriculum.

Living libraries: Nurse integration in interprofessional homeless health care team.

BACKGROUND: Despite an increase in national health care service utilization, entry into the health care system remains inequitable. This disparity in health care access disproportionately affects those experiencing homelessness. Because the homeless population faces significant financial and nonfinancial barriers, health care system engagement with these individuals must be reconsidered. OBJECTIVE: This article will describe the piloting of an interprofessional model within an urban library to address barriers to health care access that homeless individuals face. DESIGN: The library's unique status as a community hub presents an opportunity for partnership in addressing this population's health care access issues. This community-based model is the first recorded to utilize three distinct professions-nursing, social work, and library science-in a public library. RESULTS AND CONCLUSIONS: The implementation of this pilot project resulted in a high retention rate of referrals to community health services for those unstably housed and facilitated a system of warm transfers. Although opportunities to improve generalizability exist, this initiative sets the stage for discussion around co-location of health and social services in a nontraditional community-based setting to achieve equitable access to health care.

Parents' adverse childhood experiences and mental health screening using home visiting programs: A pilot study.

BACKGROUND: Adverse childhood experiences (ACEs) are associated with adult high-risk behaviors and diseases. There is value in screening parents for ACEs given the repercussions parental ACEs may have on parenting behaviors and child development. The primary aim of this study was to assess the feasibility of parental ACE screening in the home setting. A secondary aim was to evaluate whether or not maternal ACEs correlated with maternal mental health measures. METHODS: Two home visiting programs that support early childhood development and conduct parental mental health screening implemented ACE screening for parents of infants <1 year of age. Descriptive statistics were produced for population surveillance of ACEs as well as standard practice screens for depression, anxiety, substance use, and intimate partner violence. Logistic models were used to examine associations between ACE score and mental health measures. RESULTS: A total of 110 parents completed the ACE screen. All possible ACE score outcomes were represented (0-10). A trend toward association of positive prenatal maternal depression screen with ACE score was identified (p = .05). CONCLUSION: This novel prospective home-based screening program for parental ACEs was feasible and identified a trend toward increasing ACE score association with positive prenatal maternal depression screen.

Neighborhood: A Conceptual Analysis.

Researchers interested in measuring neighborhood-level effects should understand how "neighborhood" is defined within nursing sciences and other sciences, and the inherent strengths and weaknesses of current research methodologies. This concept analysis provides clarity around the concept of neighborhood within the context of health, analyzes the current state of development of the neighborhood concept, and proposes areas for future nursing research. Using the Rodger's Method of analysis, the concept of neighborhood within nursing and public health research is described based on existing literature. The concept's attributes, related concepts, antecedents, and consequences are given from the literature. Comparisons of the use of neighborhood are made between nursing, public health, sociology, and other sciences. The evolution of the concept of neighborhood throughout history is described, and important implications for future research are discussed.

Barriers to the development of community-based nursing in Iran.

Purpose: Today, the care of chronic patients and older adult people in hospitals has moved towards community-based care, and health systems focus on disease prevention, health promotion, and rehabilitation. Community-based nurses play an essential role in early identification and intervention for these conditions. On the other hand, there is an increasing trend in ageing and chronic diseases in the world especially in Iran, which increases the importance of disease prevention and public health promotion. Therefore, the current research aims to identify barriers to the development of community-based nursing in Iran. Methods: In this qualitative study, 12 semi-structured interviews were conducted with nursing experts recruited in the study by purposive sampling in 2021-2022. Interviews were recorded and transcribed and a framework analysis method was used to analyse the data. Results: The results obtained from the analysis of documents and qualitative interviews led to the identification of 4 barriers: not having a specific position, inappropriate image of nursing in society, inadequacy of education with the needs of society, and high cost of home nursing services. Conclusion: Improving the image of nursing in society, locating a special place in the health system, improving education, and adjusting the costs of home care could be the strategies that help the further development of community-based nursing (CBN).

Exploring the knowledge of community-based nurses in supporting parents of preterm babies at home: A survey-based study.

AIM: This study aimed to investigate the confidence levels, knowledge base and learning needs of community-based nurses relating to the care of preterm babies and parents, to explore what education is required and in what format. DESIGN: An online survey methodology was used. METHODS: A 32-item questionnaire was distributed via social media platforms to community-based nurses in Australia. RESULTS: Descriptive analysis was undertaken relating to knowledge base, confidence levels, previous training, learning and resource needs and barriers to education. It was deemed vital to expand confidence and knowledge in this area. Gaps in learning resources were identified and a need for more training in topics such as developmental outcomes, feeding, expected milestones, weight gain, growth trajectories and supporting parents. Online resources were the preferred format to teach key knowledge to community-based health professionals, tailored to the specific features of preterm babies and support needs of parents.

Exploring the Position of Community-Based Nursing in Iran: A Qualitative Study.

BACKGROUND: Community-based nursing focuses on providing health services to families and communities in the second and third levels of prevention and this can improve the individuals, families and communities' quality of life, and reduce the healthcare costs. The aim of this study was to explore the status of community-based nursing in Iran. METHODS: This qualitative study was conducted from March to November 2015, in Tehran, Iran, using the content analysis approach. The study setting consisted of Iran and Tehran Faculties of Nursing and Midwifery, Tehran, Iran. The purposive sampling method was used. Twenty faculty members and Master's and PhD students were interviewed by using the face-to-face semi-structured interview method. Moreover, two focus groups were conducted for complementing and enriching the study data. The data were analyzed using the Graneheim and Lundman's approach to content analysis. The trustworthiness of the study findings was maintained by employing the Lincoln and Guba's criteria of credibility, dependability, and confirmability. RESULTS: In total, 580 codes were generated and categorized into three main categories of conventional services, the necessity for creating infrastructures, and multidimensional outcomes of community-based nursing. CONCLUSION: Introducing community-based nursing into nursing education curricula and creating ample job opportunities for community-based nurses seem clearly essential.