Health literacy and obesity among native Hawaiian and Pacific Islanders in the United States.

OBJECTIVES: Our purpose was to describe relationships between demographic characteristics, body mass index (BMI), and health literacy among Native Hawaiians and other Pacific Islanders (NHPIs). DESIGN AND SAMPLE: In this cross-sectional survey, we interviewed 364 NHPI adults. MEASURES: We used Newest Vital Sign (NVS), a health literacy tool; measured heights and weights; and demographic questions. RESULTS: According to participants' NVS scores, 45.3% had at least a possibility of low health literacy. Lower NVS scores were associated with increased BMI (r = -0.12, p = .027) and increased age (r = -0.26, p < .001). Higher NVS scores were associated with higher incomes (r = 0.21, p = .001) and higher education (r = 0.27, p < .001). Women scored significantly better than men (t = -2.0, p = .05). Participants' NVS scores in Hawaii versus Utah were not significantly different (t = .26, p = .80). CONCLUSIONS: Pathways to health literacy are complex; however, age, income, education, and BMI explained a modest 19.95% of the combined variance in NVS scores. Public health nurses working to improve health literacy could include review of critical information on nutrition facts labels, frequently used calculations, and application of this information when making food choices.

COVID-19 lockdown: Impact on college students' lives.

Objective: In light of COVID-19, leaders issued stay-at-home orders, including closure of higher-education schools. Most students left campus, likely impacting their employment and social network. Leaders are making decisions about opening universities and modality of instruction. Understanding students' psychological, physiological, academic, and financial responses to the shut-down and reopening of campuses can help leaders make informed decisions. Participants: 654 students from a large western university enrolled during the pandemic shutdown. Methods: Students were invited via email to complete an online survey. Results: Students reported stress, depression, loneliness, lack of motivation, difficulty focusing on schoolwork, restless sleep, appetite changes, job loss concerns, and difficulties coping. Most wanted to return to campus and felt social/physical distancing was effective but were mixed in terms of testing or masks. Conclusions: Moving to remote learning created physical and psychological stress. Students want to return to campus but do not want to take risk-reducing measures.

In an era of uncertainty: Impact of COVID-19 on dental education.

PURPOSE/OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic arguably represents the worst public health crisis of the 21st century. However, no empirical study currently exists in the literature that examines the impact of the COVID-19 pandemic on dental education. This study evaluated the impact of COVID-19 on dental education and dental students' experience. METHODS: An anonymous online survey was administrated to professional dental students that focused on their experiences related to COVID-19. The survey included questions about student demographics, protocols for school reopening and student perceptions of institutional responses, student concerns, and psychological impacts. RESULTS: Among the 145 respondents, 92.4% were pre-doctoral dental students and 7.6% were orthodontic residents; 48.2% were female and 12.6% students lived alone during the school closure due to the pandemic. Students' age ranged from 23 to 39 years. Younger students expressed more concerns about their emotional health (P = 0.01). In terms of the school's overall response to COVID-19, 73.1% students thought it was effective. The majority (83%) of students believed that social distancing in school can minimize the development of COVID-19. In general, students felt that clinical education suffered after transitioning to online but responded more positively about adjustments to other online curricular components. CONCLUSIONS: The COVID-19 pandemic significantly impacted dental education. Our findings indicate that students are experiencing increased levels of stress and feel their clinical education has suffered. Most students appear comfortable with technology adaptations for didactic curriculum and favor masks, social distancing, and liberal use of sanitizers.

The impact of migration on the health of voluntary migrants in western societies.

The authors reviewed literature on the health of voluntary migrants to Western societies and factors affecting their health. Health indicators include mortality rates and life expectancy, birth outcomes, risk of illness, patterns of deteriorating health, cardiovascular disease, body mass index, hypertension, and depression. Multiple factors explain variability, including length of residence and acculturation, disease exposure, life style and living conditions, risky behaviors, healthy habits, social support networks, cultural and linguistic barriers, experiences with racism, and levels of awareness of cultural health practices among health care providers. Evidence exists for superior health among many migrants to Western countries relative to native-born persons, but the differential disappears over time. Migration is a dynamic, extended process with effects occurring years after physical relocation. Systemic change is required, including health policies that ensure equity for migrants, culturally appropriate health promotion, and routine assessment of migration history, cultural health practices, and disease exposure.

Successfully incorporating Writing Across the Curriculum with advanced writing in nursing.

The purpose of this article is to explain the concepts of Writing Across the Curriculum, Writing in the Disciplines, and Writing to Learn, and to describe the incorporation of advanced writing into a baccalaureate nursing program and provide suggestions for accessing resources and promoting success. The goals of incorporating Writing Across the Curriculum, Writing in the Disciplines, and Writing to Learn concepts into nursing curriculum are to assist nursing students to achieve competence in clinically relevant writing assignments; to demonstrate critical thinking and communication skills, both oral and written; to execute useful literature searches; to read and understand research reports; and to encourage the incorporation of evidence into clinical practice. With a strong and established writing foundation, nursing students will be more successful in written and oral communication during their nursing program and throughout their nursing career.

Does family communication matter? Exploring knowledge of breast cancer genetics in cancer families.

Knowledge of breast cancer genetics is critical for those at increased hereditary risk who must make decisions about breast cancer screening options. This descriptive study explored theory-based relationships among cognitive and emotional variables related to knowledge of breast cancer genetics in cancer families. Participants included first-degree relatives of women with breast cancer who had received genetic counseling and testing. Study participants themselves did not have breast cancer and had not received genetic counseling or testing. Data were collected by telephone interviews and surveys. Variables analyzed included numeracy, health literacy, cancer-related distress, age, education, and the reported amount of information shared by the participants' family members about genetic counseling. The multiple regression model explained 13.9% of variance in knowledge of breast cancer genetics (p = 0.03). Best fit of the multiple regression model included all variables except education. Reported amount of information shared was the only independently significant factor associated with knowledge (ß = 0.28, p = 0.01). Participants who reported higher levels of information shared by a family member about information learned during a genetic counseling session also demonstrated increased knowledge about breast cancer genetics.

Effective International Medical Disaster Relief: A Qualitative Descriptive Study.

Purpose The aim of this study was to assist organizations seeking to develop or improve their medical disaster relief effort by identifying fundamental elements and processes that permeate high-quality, international, medical disaster relief organizations and the teams they deploy. METHODS: A qualitative descriptive design was used. Data were gathered from interviews with key personnel at five international medical response organizations, as well as during field observations conducted at multiple sites in Jordan and Greece, including three refugee camps. Data were then reviewed by the research team and coded to identify patterns, categories, and themes. RESULTS: The results from this qualitative, descriptive design identified three themes which were key characteristics of success found in effective, well-established, international medical disaster relief organizations. These characteristics were first, ensuring an official invitation had been extended and the need for assistance had been identified. Second, the response to that need was done in an effective and sustainable manner. Third, effective organizations strived to obtain high-quality volunteers. CONCLUSION: By following the three key characteristics outlined in this research, organizations are more likely to improve the efficiency and quality of their work. In addition, they will be less likely to impede the overall recovery process. Broby N , Lassetter JH , Williams M , Winters BA . Effective international medical disaster relief: a qualitative descriptive study. Prehosp Disaster Med. 2018;33(2):119-126.

Psychometric testing of the healthy eating and physical activity self-efficacy questionnaire and the healthy eating and physical activity behavior recall questionnaire for children.

PURPOSE: The purpose of this study was to develop and assess the psychometric properties for two related questionnaires: the Healthy Eating and Physical Activity Self-Efficacy Questionnaire for Children (HEPASEQ-C) and the Healthy Eating and Physical Activity Behavior Recall Questionnaire for Children (HEPABRQ-C). DESIGN AND METHODS: HEPASEQ-C and HEPABRQ-C were administered to 517 participating children with 492 completing. Data were analyzed to evaluate for reliability and validity of the questionnaires. RESULTS: Content validity was established through a 10-person expert panel. For the HEPASEQ-C, item content validity index (CVI) ranged from 0.80 to 1.00. The CVI for the total questionnaire was 1.0. All HEPASEQ-C items loaded on a single factor. Cronbach's alpha was deemed acceptable (.749). For the HEPABRQ-C, item CVI ranged from 0.88 to 1.00. CVI for the total questionnaire was 1.0. Pearson product moment correlation between HEPASEQ-C and HEPABRQ-C scores was significant (r = .501, p = .000). PRACTICE IMPLICATIONS: The HEPASEQ-C and HEPABRQ-C are easily administered and provide helpful insights into children's self-efficacy and behavior recall. They are easy to use and applicable for upper elementary school settings, in clinical settings for individual patients, and in health promotion settings.

Family photographs: expressions of parents raising children with disabilities.

The purpose of this qualitative, descriptive study was to capture the everyday lives of parents raising a child with a disability. Fifteen parental dyads raising a child with Down syndrome, developmental disabilities, visual impairments, or speech disorders used a disposable camera to photograph images important to them. Interviews about these photographs reflected everyday life. Four themes emerged from content analysis of the photos: active activities, quiet activities, activities of daily living, and care of the child with a disability. Six themes emerged when discussing photographs participants would have liked to take but did not. These themes were acceptance, concern for the future, joys, struggles, balance of good and bad times, and normalcy. Findings support the usefulness of photography as a method of obtaining information from parents raising a child with a disability through qualitative means and provide nurses with a beginning understanding of these parents' lives.

The effectiveness of complementary therapies on the pain experience of hospitalized children.

Pain is a complex phenomenon for children, and the concepts of hospitalization and pain are often linked in the minds of children. Despite best-practice guidelines and standards related to pain management, many hospitalized children continue to have unrelieved pain. This suggests that analgesics alone do not sufficiently relieve their discomfort. Complementary therapies may have an important role in holistic pediatric pain management. This review of literature evaluates available evidence related to the use and effectiveness of complementary therapies on the pain experience of children in hospital settings. Thirteen recent research articles relative to this topic were located and included in this review. A variety of complementary therapies, including relaxation, distraction, hypnosis, art therapies, and imagery, are included. Results of the research are mixed, and further investigation is required.

Consulting with children in the development of self-efficacy and recall tools related to nutrition and physical activity.

PURPOSE: This article chronicles our efforts to develop an instrument with and for children-complete with insights, multiple iterations, and missteps along the way. The instruments we developed assess children's self-efficacy and recall related to healthy eating and physical activity. DESIGN AND METHODS: Five focus groups were held with 39 children to discuss the evolving instrument. RESULTS: A nine-item self-efficacy instrument and a 10-item recall instrument were developed with Flesch-Kincaid grade levels of 1.8 and 4.0, respectively, which fifth graders can complete in less than 5 min. PRACTICE IMPLICATIONS: When assessing children in clinical practice or research, we should use instruments that have been developed with children's feedback and are child-centered. Without that assurance, assessment results can be questionable.

The relationship between select demographic characteristics and body mass index among Native Hawaiian and other Pacific Islander caregiving adults.

PURPOSE: Native Hawaiian and other Pacific Islanders (NHOPIs) have the highest prevalence of overweight and obesity in the world. We identified the proportion of our NHOPI sample in each body mass index (BMI) category and explored relationships between BMI and demographic characteristics. DESIGN/METHOD: Our descriptive correlational study included 364 NHOPI caregiver adults in Utah (n = 155) and Hawaii (n = 209). We gathered demographic information with a questionnaire. Height and weight were measured for BMI calculations. RESULTS: According to the Centers for Disease Control and Prevention's BMI categories, 84.3% of our sample was overweight or obese. Participants in Utah had significantly higher BMIs than participants in Hawaii. Educational attainment was inversely related with BMI; however, age, gender, and income were not significantly related with BMI. DISCUSSION: NHOPIs on the U.S. mainland may be at greater risk for obesity than those in Hawaii; food price differences between locations may help explain this. NHOPIs in early adulthood had high BMIs; overtime this situation could worsen without intervention. IMPLICATIONS FOR PRACTICE: NHOPIs with low education levels or in areas of low food prices are at increased risk for obesity. Future research should focus on culturally sensitive interventions to reduce NHOPI obesity and associated risks.

Perceptions of health and well-being held by Native Hawaiian migrants.

BACKGROUND AND PURPOSE: Migration is often a challenging process. Native Hawaiians migrate from Hawaii to Las Vegas at an impressive rate, but no research has explored how migration affects their health and well-being. The purpose was to describe how Native Hawaiians in Las Vegas perceive their health and well-being and any changes therein since migrating. DESIGN: Using a qualitative descriptive design, 27 participants took part in semistructured interviews. FINDINGS: Most participants perceived no changes in health and minor changes in well-being. Many maintained their well-being by adapting valued activities to their new circumstances. However, 5 participants were deeply burdened by life in Las Vegas or longing for Hawaii, and their well-being suffered. They tended to identify barriers to well-being rather than ways to foster it. CONCLUSION: Health care providers can help Native Hawaiian migrants by encouraging early access to the health care system in their new location and facilitating participation in helpful, adaptive behaviors.

The integral role of food in Native Hawaiian migrants' perceptions of health and well-being.

PURPOSE: Obesity is prevalent among Native Hawaiians, but the relationship between food and perceptions of health and well-being is not well understood. The purpose was to explore the role of food in Native Hawaiians' perceptions of health and well-being. DESIGN: A qualitative descriptive design was used. Twenty-seven Native Hawaiian participants in Las Vegas took part in semistructured interviews. RESULTS: Participants expressed that food can be dangerous to health. However, eating Hawaiian food seems to relieve homesickness, and they occasionally indulge in binge overeating. CONCLUSIONS: Hawaiian food plays an important role in participants' health and well-being. Participants' concurrent attraction to Hawaiian-style food and desire to avoid unhealthy food create a challenging struggle. IMPLICATIONS: To support cultural connectedness, Native Hawaiians can be encouraged to expend consumed calories in physical activity as their ancestors did. Discussing nutrition from a family framework might be helpful to Native Hawaiians.

Improving the experience of hospitalization for Hawaiian children on the mainland through cultural sensitivity to Hawaiian ways of healing.

The experience of hospitalization for Hawaiian children on the mainland might be improved through the understanding and development of cultural sensitivity to Hawaiian ways of healing. This article contains a selected review of the literature on meeting the cultural health care needs of Hawaiian children and their families, a discussion of some of the challenges of caring for Hawaiian children in Utah, and suggestions for practice that may improve the experience of hospitalization for Hawaiian children in general.

Health care barriers for Latino children and provision of culturally competent care.

The demography of the United States is rapidly changing. The impressive growth rate of Latino populations within the United States has great impact on health care. This article includes discussion of a significant increase from 1988 to 2000 in Latino utilization of emergency department and inpatient services at a pediatric medical center in Salt Lake City, Utah, information on health care barriers for Latinos, and suggestions for providing culturally competent care.

Medical errors, drug-related problems, and medication errors: a literature review on quality of care and cost issues.

Medical errors have received a great deal of attention in recent years. The phrase medical errors is an umbrella term for all errors that occur within the health care system, including mishandled surgeries, diagnostic errors, equipment failures, and medication errors. This article is a review and discussion of the literature on the scope of medical errors, with a focus on drug-related problems and medication errors. Cost and quality ideas for addressing these issues are provided.