Five Dimensions of Needs for Help: The Efficacy of a Technology-Based Intervention Among Asian American Breast Cancer Survivors.

Cancer survivors including Asian American breast cancer survivors have reported their high needs for help during their survivorship process. With the COVID-19 pandemic, the necessity of technology-based programs to address their needs for help without face-to-face interactions has been highlighted. The purpose of this randomized intervention study was to determine the efficacy of a technology-based program in reducing various types of needs for help among this specific population. This was a randomized clinical trial with repeated measures. A total of 199 participants were included in the data analysis. The recruitment settings included both online and offline communities/groups for Asian Americans. The needs for help were assessed using the Support Care Needs Survey-34 Short Form (SCNS) subscales measuring psychological, information, physical, support, and communication needs. Data analysis was conducted through an intent-to-treat approach. In the mixed effect models, psychological needs, information needs, physical needs, and communication needs decreased over time (P < .001). However, there were no significant group * time effects. Social support significantly mediated the effects of a technology-based intervention on psychological, information, and support needs at the pre-test and the post-1 month. This study supported significant decreases in the needs for help of Asian American breast cancer survivors by a technology-based intervention. Further studies are needed with other racial/ethnic groups of cancer survivors to confirm the efficacy of a technology-based intervention in reducing cancer survivors' needs for help during their survivorship process.

Community sharing: Contextualizing Western research notions of contamination within an Indigenous research paradigm.

Báa nnilah is a chronic illness self-management program designed by and for the Apsáalooke (Crow) community. Arising from a collaboration between an Indigenous nonprofit organization and a university-based research team, Báa nnilah's development, implementation, and evaluation have been influenced by both Indigenous and Western research paradigms (WRPs). Báa nnilah was evaluated using a randomized wait-list control group design. In a WRP, contamination, or intervention information shared by the intervention group with the control group, is actively discouraged as it makes ascertaining causality difficult, if not impossible. This approach is not consonant with Apsáalooke cultural values that include the encouragement of sharing helpful information with others, supporting an Indigenous research paradigm's (IRP) goal of benefiting the community. The purpose of this paper is to address contamination and sharing as an area of tension between WRP and IRP. We describe how the concepts of contamination and sharing within Báa nnilah's implementation and evaluation are interpreted differently when viewed from these contrasting paradigms, and set forth a call for greater exploration of Indigenous research approaches for developing, implementing, and evaluating intervention programs in Indigenous communities. (Improving Chronic Illness Management with the Apsáalooke Nation: The Báa nnilah Project.: NCT03036189), ClinicalTrials. gov: NCT03036189).

The Refined Middle-Range Theory on Women's Leadership in Asian Culture.

Introduction: Because virtually no theories were available to explain unique characteristics of Asian women's leadership in nursing, a middle-range theory on women's leadership in Asian culture was previously published. To reflect recent political and social changes in different countries, there is a necessity to refine the theory. The purpose of this article is to present the refined middle-range theory on Asian women's leadership in nursing. Methodology: Using an integrative approach, the theory was further developed based on two major sources: literature reviews and exemplars/cases from six different countries. Results: The Refined Middle-Range Theory on Women's Leadership in Asian Culture has two main domains: (a) leadership frames and (b) leadership contexts. The domain of leadership contexts has been extended with two additional main concepts including demographic contexts and health workforce/system contexts. Discussion: The refined theory is expected to guide Asian women's leadership in nursing across the globe.

The Use of Mobile Health to Assist Self-management and Access to Services in a Rural Community.

The purpose of this study was to explore the barriers to and needs for using mobile health technology to assist low-income Asian American and Pacific Islander participants living in rural Hawaii in their healthcare. Three focus groups consisting of patients, family support/significant others, and providers (N = 19) were conducted to assess the unique needs of low-income Asian American and Pacific Islander patients in rural Hawaii. The electronic health literacy scale was also used among participants in the patients and family support/significant other groups. The total electronic health literacy means were 23.57 (SD = 9.71) among participants in the patient group, 34.50 (SD = 7.78) in the family support/significant others group, and 35.67 (SD = 4.56) in the providers group. The qualitative analysis yielded categories with three main themes: value of mobile health, stumbling blocks to mobile health, and mobile health wish list and subthemes. Practice implications include uses of these findings to integrate future versions of mobile health that will promote effective communication and information specifically to diverse low-income populations.

A Systematic Review of Adolescent Self-Management and Weight Loss.

INTRODUCTION: The aim of this review is to evaluate self-management interventions among overweight and obese adolescents to direct future research and practice. METHODS: Studies published between 2008 and 2014 were identified by electronic database searches. The Jadad Scoring of Quality Reports of Randomized Clinical Trials was used to evaluate the quality of the studies with subsequent reviews. RESULTS: Out of 69 studies, 10 randomized controlled trials were reviewed after all inclusion and exclusion criteria were met. Quality scores ranged from 7 to 11 out of 13 (M = 9.2, SD = 1.13). For the majority of studies, self-management strategies for weight loss were found to be significant for a mix of behavioral, psychological, anthropometric, and metabolic outcomes. DISCUSSION: Findings indicated that interventions were most successful when incorporating family members. Self-management interventions that include a combination of appropriate diet, physical activity, and behavioral strategies with a family component are recommended.

Translational research education and training needs in Hawai'i.

The purpose of this needs assessment was to identify the translational research education and training needs of researchers and administrators working in Hawai'i's communities and to use the finding to develop an education and training plan. The assessment was led by a community advisory board with members from community health centers, social agencies, hospitals, and academia on O'ahu. The survey, developed with input of the community advisory board, was sent to 94 administrators and researchers involved or affiliated with research being conducted in Hawai'i. Forty-one respondents (43%) completed the survey. Respondents wanted education and training in research processes, specific research-related skills, and facilitating interactions between community and academic researchers. Sixty-one percent were interested in training related to community-engaged research and yearly seminars on "collaborative mentoring." Popular topics of interest were related to data monitoring, networking with different cultural groups, statistics, and human subjects review. A majority of respondents wanted to attend workshops, seminars, and presentations rather than take a class. Approximately 50% of the respondents wanted to gain information through on-line training. Findings guided the development of a translational research education and training plan for the University of Hawai'i National Institute of Health (NIH) Research Centers in Minority Institutions Multidisciplinary and Translational Research Infrastructure Expansion (RMATRIX) grant.

Partnership to build research capacity.

Today's nursing leaders are setting the stage for the next evolution--bringing together skilled clinicians and administrators with peers in education to create new approaches to leading the profession forward. Partnerships share goals, common purpose, mutual respect, willingness to negotiate and compromise, informed participation, information giving, and shared decision making. The shared practice academia effort between a public university and a private health care system situated in the island state of Hawai'i is described. The medical center and school of nursing pursued individual strategic efforts to build research capacity and used the opportunity to fund academic practice research projects. The mutual need and recognition of the high stakes involved, in concert with stable, committed leaders at all levels, were key to the early success of their efforts. Through the formal research partnership mechanism, a discrete focus was created for efforts and used to move to tactical, operational, and interpersonal integration in this relationship.

Factors influencing osteoporosis preventive behaviours: testing a path model.

AIM: This paper is a report of a study to test a model of certain factors influencing people engaging in osteoporosis preventive behaviours, and to estimate the direct and indirect effects of personal and social factors on whether people engage in those behaviours. BACKGROUND: Osteoporosis preventive behaviours, including exercise and calcium intake, help decreasing the risk of developing osteoporosis. Reasons for engaging in osteoporosis preventive behaviours are complex and influenced by personal and social factors. Years of education, self-efficacy, knowledge of osteoporosis, social support and social capital have been indicated to increase people engaging in osteoporosis preventive behaviours; but age has been shown to decrease those behaviours. METHODS: The proposed model was developed using Social Cognitive Theory and a conceptual framework for addressing the social context of health behaviour. A correlational cross-sectional study was carried out in 2005, using questionnaires and a convenience sample of 243 participants. Data analysis included descriptive statistics, correlation techniques and path analysis. RESULTS: Self-efficacy was a better predictor of engaging in osteoporosis preventive behaviours than were the other variables. Social capital had a statistically significant direct and indirect effect on osteoporosis preventive behaviours. The modified path model showed good fit with the data. CONCLUSION: The associations between personal and social factors extend our knowledge from previous studies and increase our understanding of the complex relationships among the study variables. The model provides guidance for future nursing practice, research, and education programs related to osteoporosis prevention.

Health disparities among Asian Americans and Pacific Islanders.

The Asian American and Pacific Islander (AAPI) group is the fastest-growing minority group in the United States. AAPIs have been touted in the literature as the "model minority" because of their achievements in the socioeconomic and educational spheres, which in certain categories are beyond the average levels of the dominant majority. However, generalizations such as these are very misleading, because they mask the glaring health disparities that are experienced by subgroups within the AAPI population. The purpose of this chapter is to explore the literature dealing with health disparities among AAPIs. Twenty-eight usable research reports were reviewed after a thorough review of the literature that spanned the years between 1990 and 2003. The review has revealed that the predominant psychosocial and cultural variables studied in research dealing with AAPI are acculturation, family and social networks, help-seeking behaviors, and cultural brokering. In general, research conducted on this group tended to be at the descriptive and comparative-correlational levels; more studies that investigate the effects of interventions to reduce or eliminate health disparities on this group are needed. The challenge is to build a body of knowledge on which to base future action.