Initial evaluation of the Robert Wood Johnson Foundation Nurse Faculty Scholars program.

BACKGROUND: The Robert Wood Johnson Foundation Nurse Faculty Scholars (RWJF NFS) program was developed to enhance the career trajectory of young nursing faculty and to train the next generation of nurse scholars. Although there are publications that describe the RWJF NFS, no evaluative reports have been published. The purpose of this study was to evaluate the first three cohorts (n = 42 scholars) of the RWJF NFS program. METHODS: A descriptive research design was used. Data were derived from quarterly and annual reports, and a questionnaire (seven open-ended questions) was administered via Survey Monkey Inc. (Palo Alto, CA, USA). RESULTS: During their tenure, scholars had on average six to seven articles published, were teaching/mentoring at the graduate level (93%), and holding leadership positions at their academic institutions (100%). Eleven scholars (26%) achieved fellowship in the American Academy of Nursing, one of the highest nursing honors. The average ratings on a Likert scale of 1 (not at all supportive) to 10 (extremely supportive) of whether or not RWJF had helped scholars achieve their goals in teaching, service, research, and leadership were 7.7, 8.0, 9.4, and 9.5, respectively. The majority of scholars reported a positive, supportive relationship with their primary nursing and research mentors; although, several scholars noted challenges in connecting for meetings or telephone calls with their national nursing mentors. CONCLUSIONS: These initial results of the RWJF NFS program highlight the success of the program in meeting its overall goal-preparing the next generation of nursing academic scholars for leadership in the profession.

Overcoming the triad of rural health disparities: How local culture, lack of economic opportunity, and geographic location instigate health disparities.

OBJECTIVE: To discuss how the effects of culture, economy, and geographical location intersect to form a gestalt triad determining health-related disparities in rural areas. METHODS: We critically profile each component of the deterministic triad in shaping current health-related disparities in rural areas; evaluate the uniquely composed intersections of these disparities in relation to Human Papillomavirus (HPV)-related cancer prevention in three isolated rural Georgia counties; and develop implications for future leadership in rural healthcare research, policy, and practice. RESULTS: The deterministic triad of culture, economy, and geographical location is unique to a rural community, and even if two rural communities experience the same health disparity, each community is likely to have a discretely different composition of cultural, economic, and geographic determinants. CONCLUSION: The deterministic triad presents a challenge for health policymakers, researchers, and practitioners trying to develop health-related interventions that are equitable, efficacious, and practical in low-resource rural communities. The situation is worsened by the limited opportunities for employment, which leads to greater disparities and creates propagating cultural norms that further reduce access to healthcare and opportunities for sustainable health promotion.

Symptoms and risk factors associated with first urinary tract infection in college age women: a prospective cohort study.

PURPOSE: We identified epidemiological risk factors for the initial urinary tract infection in females of college age compared to age matched controls. MATERIALS AND METHODS: We performed a prospective cohort study from July 2001 to January 2006 at the student health care facility at our institution. A total of 180 women experiencing a first urinary tract infection were compared to 80 asymptomatic women with no urinary tract infection history who served as controls. Urinalysis and urine culture were done at study enrollment. Questionnaires were used to obtain information on clinical symptoms and behaviors, including sexual and dietary practices, and alcohol consumption. Logistic regression was performed to identify potential risk factors in women who presented with an initial urinary tract infection compared with controls. Principal component analysis was then done to identify key sexual activity variables for multiple regression models. RESULTS: Urinary frequency and urgency were the most common urinary tract infection symptoms. Recent sexual activity was a significant risk factor for urinary tract infection with vaginal intercourse (p = 0.002) and the number of sexual partners in the last 2 weeks (p <0.001) as the 2 primary variables. Alcohol consumption was associated with 2 of the 3 main principal components of sexual activity. Caffeinated beverage consumption also increased the risk of urinary tract infection (p <0.04). Escherichia coli was the predominant pathogen isolated, followed by urease positive microbes. CONCLUSIONS: Recent sexual activity, the frequency of that activity and the number of sexual partners pose an increased risk of urinary tract infection. Alcohol consumption frequency and amount correlated with these behaviors.

The Robert Wood Johnson Foundation Nurse Faculty Scholars Program: an opportunity for junior nurse faculty.

The Robert Wood Johnson Foundation Nurse Faculty Scholars program provides promising junior faculty extramural funding, expert mentoring, and the training needed to be successful in the academic role. The Nurse Faculty Scholars program, which admitted its first cohort in 2008, is designed to address the nursing faculty shortage by enhancing leadership, educational, and research skills in junior nursing faculty. This article provides an overview of the program, its purpose, and its eligibility requirements. The authors give strategies for selecting mentors, developing the written application, and preparing for an oral interview. Finally, the authors provide an analysis of funded institutions, research design and methods from current and recently funded projects, and rank and positions held by nursing mentors.

Cultural Values Influencing Immigrant Haitian Mothers' Attitudes Toward Human Papillomavirus Vaccination for Daughters.

Although research has shown that mothers significantly influence daughters' willingness to be vaccinated against the human papillomavirus (HPV), cultural factors influencing immigrant Haitian mothers' willingness to have adolescent daughters to be vaccinated are unknown. This is of concern as this population experiences disproportionately higher rates of HPV infection and related cervical cancers. This study identifies cultural beliefs influencing 31 immigrant Haitian mothers' willingness to vaccinate their daughters against HPV using semistructured interviews. Mothers had low levels of HPV and HPV vaccine knowledge, and desired more information. Concerns centered on cultural values regarding adolescent sexuality and HIV/AIDS stigmas specific to Haitian communities. If vaccination were recommended by a physician, mothers are more likely to have their daughters vaccinated. HPV vaccination uptake efforts targeting Haitian months should emphasize physician involvement and incorporate culturally relevant health concerns.

The Influence of Skin Color on Heterosexual Black College Women's Dating Beliefs.

Black women's skin color perceptions were identified utilized qualitative methods. The primary goal was to identify the relevance of these perceptions on their understandings about dating preferences and related beliefs about appropriate scripts using a Black feminist thought framework. Twenty- eight self- identified Black women attending a large university in the southeastern United States were interviewed for this study. Lighter- skin was perceived as being more attractive, and associated with four themes about dating: (a) positive personality traits, (b) increased value in dating contexts, and (c) sexual appeal to men. Therapeutic considerations for addressing skin color concerns with Black female clients, including addressing within group differences and validation of skin color values, are addressed.

Project genesis: self-reported religiosity and spirituality and sexual risk-taking in young African-American women attending a historically African-American college.

This pilot study explored the relationship between self-reported religiosity, spirituality, and sexual risk-taking. The participants were a convenience sample of (N = 100) female students attending a historically African-American college (HBCU) in the south. On this predominantly female campus, students completed an anonymous health-risk survey, plus additional items, to measure their religiosity and spirituality. Correlation analysis revealed that although these students reported a high degree of religiosity and spirituality, these characteristics did not predict a decrease in sexual risk-taking behavior. Over six million new cases of sexually transmitted infections (STIs), including the human papilloma virus (HPV), are projected in young Americans despite primary prevention measures. Although no predictive relationships were noted, self-reported spirituality or religiosity were not protective factors against high-risk sexual behavior. These findings are relevant to developing effective interventions in this population in order to decrease STI/HPV rates.

Predicting incidence and asymptomatic rates for chlamydia in small domains.

AIM: This article is a report of a study of the use of predictive analysis using the Bayesian hierarchical model and small area estimation as an innovative methodology to address the challenges nurses face when managing fiscal and clinical resources in outpatient and inpatient settings. BACKGROUND: Nurses responsible for clinic management are confronted with the fiscal challenges in today's healthcare environment. Identifying those at risk for asymptomatic infections such as chlamydia and getting resources to that group has been a constant nursing care challenge for those in outpatient and inpatient clinics. METHODS: A secondary analysis of quantitative survey data was conducted in 2008, using predictive analysis with the Bayesian hierarchical model and small area estimation of statistics. DISCUSSION: The development of an innovative statistical procedure is an interesting and challenging opportunity. The opportunity to apply this innovative technique to an actual data set opens the possibility to replicating the technique and using it in other settings. If implemented and replicated, this innovative analysis can become a tool for managing limited fiscal and clinical resources. RESULTS: White, Hispanic and African American undergraduate students had slightly higher rates than the corresponding graduate students. The incidence rates were higher for White, Hispanic and African American undergraduate students than for graduate students. The incidence rates for African Americans were much higher than for the other identified racial groups, but very similar for graduate students and undergraduate students. CONCLUSION: Predictive analysis using the Bayesian hierarchal model and small area estimation can help nurses to project healthcare costs and services for underserved groups in healthcare clinics, with an improved empirical rationale.

A short report: parents HPV vaccine knowledge in rural South Florida.

An exploratory pilot descriptive research study was conducted in the rural counties of Hendry and Glades Florida exploring parental knowledge and hesitancy of HPV vaccination. Participants included parents/caregivers with children ages 9 to 13; using quantitative methods, we evaluated knowledge, feelings, and beliefs toward HPV vaccination including vaccination prevalence and correlates among participating parents/caregivers. Our measures included the Parental HPV Survey with a Cronbach's alpha of .96. Hesitancy-focused results revealed 26% of parents showed caution because of stigma around vaccination while attributing low levels of knowledge about HPV vaccination; 80% had a persistent belief HPV vaccination could leave their child sterile, perpetuating hesitancy. Participants with a high-school education or less (64%) and conservative religious affiliation, e.g., Baptist and Catholic (74%), did not decline HPV vaccination. Results are striking considering research indicating conservative religious views and lack of a college education leads to lower HPV vaccination rates. Numerous interventions to increase HPV vaccination have been studied including strong recommendations for increased provider communication but our data indicates increasing public education with community input and a focus on cultural norms in each specific rural community among parents and providers is needed to increase HPV vaccine knowledge and decrease HPV vaccine hesitancy.

The new human papillomavirus (HPV) vaccine: pros and cons for pediatric and adolescent health.

The new human papillomavirus (HPV) vaccine is a research breakthrough for pediatric/adolescent health to prevent cervical cancer and related morbidity. The annual heath care cost for the treatment of cervical cancer and genital warts is estimated to be more than three billion dollars a year. The new HPV vaccine has incredible potential to improve reproductive health promotion, reduce health care costs, and close health care disparity gaps. However, issues both for and against the new HPV vaccine, including mandating vaccination, high cost of the vaccine, the short duration of protection offered, and the perceived promotion of sexual activity, cause confusion. Pediatric nurses, including those in advanced practice, benefit by understanding the pros and cons of these issues in advocating for their patients.

Sexual Risk Behaviors of African American Adolescent Females: The Role of Cognitive and Religious Factors.

INTRODUCTION: African American (AA) high school-age girls are more likely to have had sex before age 13 years and have higher rates of all sexually transmitted infections. Cognition and religion/spirituality are associated with adolescent sexuality, therefore, the purpose of this study was to identify cognitive and religious substrates of AA girls' risky sexual behaviors. METHOD: A descriptive study was conducted with 65 AA girls aged 15 to 20 years using computerized questionnaires and cognitive function tasks. RESULTS: Average age was 17.8 ± 1.9 years and average sexual initiation age was 15.5 ± 2.6 years. Overall, 57.6% reported a history of vaginal sex. Girls who reported low/moderate religious importance were significantly younger at vaginal sex initiation than girls for whom religion was very/extremely important. Girls who attended church infrequently reported significantly more sexual partners. IMPLICATIONS: Health care providers can use these findings to deliver culturally congruent health care by assessing and addressing these psychosocial factors in this population.

Cancer Prevention: HPV Vaccination.

OBJECTIVES: To provide an overview of human papillomavirus (HPV) vaccination as cancer prevention with current strategies that nurses can use to help patients and parents overcome barriers to HPV vaccination. DATA SOURCES: Peer-reviewed literature, presentation abstracts, and current immunization recommendations from the Advisory Council on Immunization Practice. CONCLUSION: Nurses can help prevent cancer by encouraging HPV vaccination during routine immunization and make HPV vaccination normal and routine. IMPLICATIONS FOR NURSING PRACTICE: A vaccine to reduce/eliminate HPV-related cancers enables nurses' at all educational levels to advocate for cancer prevention through initiation and completion of the HPV vaccine series.

Factors Motivating HPV Vaccine Uptake Among Vaccinated and Nonvaccinated Hispanic Young Adult Women.

INTRODUCTION: To identify factors influencing human papillomavirus (HPV) vaccination up taking decision making among vaccinated and nonvaccinated Hispanic college women. PARTICIPANTS: Hispanic young women between the ages of 18 and 24 years (N = 49). In total, 26 had not received the HPV vaccine, and 23 had started/completed the vaccine series. METHOD: Participants registered for the study via a psychology research pool at a large public university in the southeast United States after institutional review board approval. After completing a demographic information and HPV knowledge Web-based survey, participants were individually interviewed. RESULTS: Differences in HPV vaccine knowledge emerged between vaccinated and nonvaccinated women. Fear of side effects, perceptions of risk, and sources of encouragement influenced willingness to be vaccinated against HPV. Health care providers played a central role in addressing concerns and promoting vaccination. CONCLUSIONS: Health care providers must address and integrate unique decision-making processes influencing Hispanic young adult women's perceptions of HPV vaccination.

Young Hispanic Men and Human Papillomavirus Vaccination Choices.

This exploratory descriptive study examined perceived vulnerabilities to human papillomavirus (HPV) and the correlation to factors influencing vaccine beliefs and vaccine decision making in young Hispanic males attending a large public urban university. Only 24% of participants believed that the HPV vaccine could prevent future problems, and 53% said they would not be vaccinated. The best predictors of HPV vaccination in young Hispanic men were agreement with doctor recommendations and belief in the vaccine's efficacy. Machismo cultural norms influence young Hispanic men's HPV-related decision making, their perceptions of the vaccine, and how they attitudinally act on what little HPV information they have access to. This study provides culturally relevant information for the development of targeted health education strategies aimed at increasing HPV vaccination in young Hispanic men.

Assessing the Critical Parameters of eSMART-MH: A Promising Avatar-Based Digital Therapeutic Intervention to Reduce Depressive Symptoms.

PURPOSE: To assess, from the young adults' (YAs') perspectives, the critical parameters (necessity, acceptability, feasibility, fidelity, and safety) of an avatar-based intervention, eSMART-MH, to reduce depressive symptoms. DESIGN AND METHODS: YAs (n = 60) were randomly assigned to eSMART-MH or control and observed for 12 weeks. Qualitative and quantitative data were collected. FINDINGS: Necessity, acceptability, fidelity, and safety of eSMART-MH were supported. Feasibility results were mixed. When benchmarked against usual care, eSMART-MH demonstrated greater feasibility. PRACTICE IMPLICATIONS: eSMART-MH is a promising digital therapeutic for depressive symptoms. Feasibility can be strengthened through "on the go" access via mobile devices and Internet delivery.

Stigma Scale for Receiving Psychological Help (SSRPH): An Examination Among Adolescent Girls.

Stigma is one of the greatest obstacles to care and impedes recovery. The Stigma Scale for Receiving Professional Psychological Help (SSRPH), a measure of public stigma, has been used in young adults and has limited psychometric data in adolescents. This article reports the reliability and validity of the SSRPH in adolescent girls (N = 156, age = 13-17). Discriminant validity was supported, but concurrent validity was not. The confirmatory factor analysis revealed excellent model fit and serves as beginning evidence for construct validity. Cronbach's alpha for the SSRPH was .65. The SSRPH was stable over 8 weeks. Findings suggest that the SSRPH can serve as a foundation for further instrument development. Future studies may explore enhancing the reliability and validity of the SSRPH and use advanced analytic techniques to examine the overall global construct of stigma, the latent constructs of public and private stigma, and associations of individual items to these constructs.

Religious and Psychosocial Covariates of Health-Related Quality of Life in People Living with HIV/AIDS.

HIV/AIDS is a chronic, highly stigmatized illness that requires significant lifestyle adjustments, including consistent adherence to Antiretroviral Therapy (ART) in order for People Living With HIV/AIDS (PLWH) to survive and maintain good immune health. PLWH often report poor or moderate Health-Related Quality of Life (HRQoL) that is worse than the general population. This may be related to the psychological and physiological demands of HIV disease and the sociodemographic stressors associated with it. The role of religious coping, religiosity, and social support in the mental and physical dimensions of HRQoL is less known, although recent studies highlight that PLWH rely on spirituality/religion to cope with HIV-associated stressors. This study examined the effects of religious coping, religiosity, depressive symptoms, medication adherence, and social support satisfaction in various dimensions of Health- Related Quality of Life (HRQoL) in a sample of 292 PLWH. Majority of participants were African-American (90.1%) and 56.2% were male. Mean age was 45 years and, on average, participants lived with HIV for nearly 11 years. Descriptive statistics, correlations, Analysis of Variance (ANOVA), and hierarchical multiple linear regression were used to analyze the data. Income, sex (ß= .14), age (ß= -.14), depressive symptoms (ß= -.27), and social support satisfaction (ß= .17) significantly predicted physical HRQoL. Results indicate that income (ß= .13), sex (ß= .14), medication adherence (ß= .13), negative religious coping (ß= -.18), religious attendance (ß= .13), religiousness (ß= .16), and social support satisfaction (ß= .27) significantly predicted mental HRQoL. Depressive symptoms (ß= -.38), positive religious coping (ß= .24), and social support satisfaction (ß= .16) significantly predicted general HRQoL. Participants, who were female, prayed less than daily, attended religious services less than weekly or who were non/less religious had significantly poorer HRQoL. The findings confirm the importance of religion, mental health, medication adherence and social support in the HRQoL of PLWH, which should all be routinely assessed by clinicians.

Cross-cultural differences and sexual risk behavior of emerging adults.

PURPOSE: The authors examined population-specific risk factors that increase emerging adults' risk of acquiring sexually transmitted infections (STIs), including the human papillomavirus (HPV). DESIGN AND METHOD: A cross-sectional sample of 335 diverse, emerging adults ages 18 to 24 years was recruited from a health center at a large university in the Southeastern United States. The mean age was 20.6 ± 1.9 years, majority were females (74.0%), and 61.0% were Hispanic. RESULTS: Findings revealed inconsistent condom use, reasons for not using condoms, and a need for more culturally specific intervention strategies. DISCUSSION AND CONCLUSIONS: Healthcare providers should identify culturally specific reasons for inconsistent condom use, examine cultural and geographic differences in sexual risk behaviors among groups and communities, and modify communication, educational programs, and interventions accordingly. IMPLICATIONS FOR PRACTICE: By adopting a multicultural approach to the control of STIs, nurses can address specific cultural attitudes and behaviors that may influence exposure to STIs, including HPV.

Social Networks Influence Hispanic College Women's HPV Vaccine Uptake Decision-making Processes.

This qualitative study was designed to assess current and preferred social networks that influence human papillomavirus (HPV) vaccine decision making in a sample of Hispanic college women. Individual, semi-structured interviews were conducted with 41 Hispanic college women attending a large southeastern Hispanic-serving institution. Television commercials and discussions with mothers were found to be the most influential social networks for current HPV vaccination beliefs. Internet sites, close family members, and healthcare providers' communications were preferred social networks for HPV vaccine information. Perceived accessibility and sense of comfort influenced the order in which these social networks' communications would be accepted. Findings suggest that Hispanic college women utilize specific social networks to gather information and make decisions about HPV vaccination. Continued efforts are needed to promote further understanding of the purpose of the HPV vaccine via these preferred sources of information.

Researching and Respecting the Intricacies of Isolated Communities.

PURPOSE: Conducting research in a rural area can be challenging for nurses for a variety of different reasons. The task at hand can be especially difficult when it involves discussing a sensitive topic, such as Human Papillomavirus (HPV) vaccination. This study was conducted to describe parental perceptions of the HPV vaccine in rural areas, while simultaneously describing a method for engaging in successful nursing research in rural areas. METHODS: A team of nurse researchers completed a planned process to first understand rural culture in southeastern Georgia, and then more specifically, the families living in these three separate counties. This process initially involved developing a connection and working relationship with key community leaders, such as school principals. Following this, researchers worked on establishing rapport and trust with local parents and research participants themselves. Qualitative methods were then used to collect focus group and interview data on parental views of HPV, HPV vaccination, and HPV-related cancers. FINDINGS: Results indicated that parents had little knowledge of the HPV vaccine in rural Georgia, including misconceptions that the vaccine is for females only. In addition, many parents continually voiced the concern that the HPV vaccine would promote promiscuity in their children. CONCLUSIONS: Providing consistent, timely, and open communication with the community members was crucial throughout the entire research process. This focused approach with respect to total community, culture, and religious value is essential in conducting research. Future studies conducted in rural areas should focus on specific intervention points that improve Parental HPV knowledge.