Understanding the role of communities of practice in evidence-informed decision making in public health.

In this article we report on qualitative findings that describe public health practitioners' practice-based definitions of evidence-informed decision making (EIDM) and communities of practice (CoP), and how CoP could be a mechanism to enhance their capacity to practice EIDM. Our findings emerged from a qualitative descriptive analysis of group discussions and participant concept maps from two consensus-building workshops that were conducted with public health practitioners (N = 90) in two provinces in eastern Canada. Participants recognized the importance of EIDM and the significance of integrating explicit and tacit evidence in the EIDM process, which was enhanced by CoP. Tacit knowledge, particularly from peers and personal experience, was the preferred source of knowledge, with informal peer interactions being the favored form of CoP to support EIDM. CoP helped practitioners build relationships and community capacity, share and create knowledge, and build professional confidence and critical inquiry. Participants described individual and organizational attributes that were needed to enable CoP and EIDM.

Developing guidelines for quality community health nursing clinical placements for baccalaureate nursing students.

Rapidly increasing enrollment in Canadian schools of nursing has triggered the development of innovative clinical placement sites. There are both opportunities and challenges inherent in the delivery of clinical nursing education in diverse community settings. As part of the Canadian Association of Schools of Nursing's (CASN) ongoing work to assist its members and ensure baccalaureate graduates are prepared to meet the Canadian Community Health Nursing Standards of Practice at an entry-to-practice level, the CASN Sub-Committee on Public Health (funded by the Public Health Agency of Canada) conducted extensive national consultations with representatives from both academic and practice settings, as well as key national organizations. The resultant Guidelines for Quality Community Health Nursing Clinical Placements, released by CASN in 2010, aim to provide direction to Canadian schools of nursing and practice settings in addressing the challenges and opportunities arising from the changing context of community health nursing student clinical placements.

Development of a program logic model to measure the processes and outcomes of a nurse-managed community health clinic.

Evaluation is an essential process that permits assessing the effectiveness and efficiency of planned programs. In implementing a new nurse-managed Community Health Clinic targeting services for the homeless and underserved, the stakeholders considered an evaluation process integral to the planning stage of the clinic as a whole as well as of all the different programs being offered. The program logic model was chosen and modified to guide evaluation. Work to develop the evaluation model and its components began before the clinic opened. This article describes the development of the modified program logic model, how it was modified, and the rationale for its modifications. We highlight the process of developing the evaluation model because we found limited descriptions of the process in the literature. The evaluation process itself will be evaluated on an ongoing basis to determine if it is capturing the evaluation needs of the clinic project accurately.

Time for my life now: early Boomer women's anticipation of volunteering in retirement.

PURPOSE: This study explored to what extent early Boomer women who work for pay will be interested in and committed to formal volunteering during retirement. METHOD: Data for this hermeneutic study were gathered through 2 in-depth conversational interviews of 19 English-speaking early Boomer women living in New Brunswick, Canada. RESULTS: Interpretive analysis of interview data revealed that for these early Boomer women, consideration of volunteering in retirement revolves around analyzing the perceived costs and benefits, setting specific criteria for involvement, and recognizing the societal impacts of their refusal to volunteer or their limitation of commitment. IMPLICATIONS: Although not generalizable, the results of this study suggest administrators planning to recruit and retain retired early Boomer women to volunteer should not assume participation at the same rate or with the same commitment as previous generations. New models of volunteer recruitment and deployment may need to be developed to meet the expectations of these women. These participants indicated that formal volunteering will be for personal, not altruistic reasons, on their own terms through direct service; they are not interested in the consuming commitments of board and committee work or fundraising. Volunteering must be meaningful, something about which they are passionate and on their own schedule.

The effects of past relationship and obligation on health and health promotion in women caregivers of adult family members.

The social expectation that women will care for family members persists despite evidence that many women have difficult or abusive past relationships with their parents and partners. Little is known about how past relationship influences the health of women caring for adult family members. On the basis of earlier grounded theory research, we tested the theory that past relationship and obligation predict health outcomes and health promotion in 236 women caregivers of adult family members. Structural equation modeling demonstrated support for the theory, with 56% of the variance in health outcomes and 11% of the variance in health promotion accounted for by the model.