Training and experience of public health nurses in using behavior change counseling.

OBJECTIVE: The objective of this study was to evaluate the effectiveness, feasibility, and usefulness of a behavior change counseling (BCC) training program for public health nurses to facilitate behavior change in patients. DESIGN AND SAMPLE: This was a quasi-experimental feasibility study. Twelve rural public health nurses participated in the study. MEASURES: Nurses participated in a 1-day BCC training workshop and 2 follow-up telephone calls within 8 weeks. Their pre- and posttraining BCC skills were evaluated based on audio-taped interactions using the Behavior Change Counseling Index (BECCI). Additionally, interviews were conducted with the nurses to understand their experience with the training in the use of BCC in their practice. RESULTS: Descriptive statistics demonstrated increased BECCI scores after training. Nurses described the training workshop as valuable. Training in BCC helped nurses realize and improve their communication skills to facilitate patients' behavior changes. Nurses believed that additional training using BCC techniques in typical patient situations would help them improve their skill and confidence in using this method. CONCLUSION: Nurses found BCC to be a useful tool to facilitate patients' behavioral changes. Although training resulted in increased skill in using BCC, nurses felt that they needed additional training to master BCC skills.

Identifying genetics and genomics nursing competencies common among published recommendations.

The purpose of this article is to identify published recommendations for genetics and genomics competencies or curriculum for nurses in the United States and to summarize genetic and genomic nursing competencies based on common themes among these documents. A review of the literature between January 1998 and June 2008 was conducted. Efforts were also made to access the gray literature. Five consensus documents describing recommendations for genetics and genomics competencies for nurses meeting inclusion criteria were analyzed. Twelve genetics and genomics competencies were created based on common themes among the recommendations. These competencies include: demonstrate an understanding of basic genetic and genomic concepts, provide and explain genetic and genomic information, refer to appropriate genetics professionals and services, and identify the limits of one's own genetics and genomics expertise. The competencies represent fundamental genetics and genomics competencies for nurses on the basis of common themes among several consensus recommendations identified in the literature.

Implications for education in complementary and alternative medicine: a survey of entry attitudes in students at five health professional schools.

INTRODUCTION: The National Institutes of Health provided grants to the Oregon Health & Science University (OHSU) and 14 other allopathic academic health centers for the development of curricula in complementary and alternative medicine (CAM). A key component of the curriculum evaluation for OHSU was provided by a survey assessing attitudes toward CAM and selected personality characteristics of entering students in chiropractic, naturopathic, Oriental, and allopathic medicine in the Pacific Northwest and Upper Midwest. METHODS: A survey containing a variety of assessments of attitudes toward CAM and the personality traits of adventurousness and tolerance to ambiguity was administered to students entering four Portland, Oregon doctoral-level health professional schools and an allopathic medical school in the Upper Midwest (University of Nebraska College of Medicine) during the 2004-2005 academic year. RESULTS: Students of naturopathy (n = 63) and Oriental Medicine (n = 71) were the most "CAM positive," adventurous and tolerant of ambiguity, and Midwestern allopathic medical students (n = 58) the least. In general, chiropractic students (n = 89) and allopathic medical students from the Pacific Northwest (n = 95) were intermediate in CAM attitudes between these two groups (all p < 0.05). Female students were more "CAM positive" in all schools compared to male students. CONCLUSIONS: Students have high levels of interest in CAM upon entrance to their schools. Health professional discipline, geographic location, personality qualities, and gender appear to influence CAM attitudes in entering students.

Response to a proposal for an integrative medicine curriculum.

BACKGROUND: A paper entitled "Core Competencies in Integrative Medicine for Medical School Curricula: A proposal," published in Academic Medicine, stimulated a broad discussion among complementary and alternative medicine (CAM) educators. This discussion led to a formal process for responding to the issues raised by the paper. METHODS: Representatives from the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) and the Oregon Collaborative for Complementary and Integrative Medicine (OCCIM) formed the ACCAHC/OCCIM Task Force to participate in a Delphi process of consultation and deliberation. This process led to a broad, cross-discipline agreement on important points to include in a response to the integrative medicine (IM) curriculum proposal. RESULTS: Five key areas of concern emerged: (1) the definition of IM as presented in the paper; (2) lack of clarity about the goals of the proposed IM curriculum; (3) lack of recognition of the breadth of whole systems of health care; (4) omission of competencies related to collaboration between MDs and CAM professionals in patient care; and (5) omission of potential areas of partnership in IM education. CONCLUSIONS: A major overall theme emerging from the Delphi process was a desire for closer collaboration between conventional medical schools and CAM academic institutions in developing IM curricula. Several cross-disciplinary venues for addressing the Delphi Task Force themes include the National Center for Complementary and Alternative Medicine's R-25 Initiatives, and the National Education Dialogue. OCCIM is presented as an example of a successful lateral integration approach.

Feasibility of a virtual health and wellness center for the Oregon Air National Guard.

A cross-sectional survey of members was used to examine the feasibility of developing a virtual health and wellness center in the Oregon Air National Guard. The survey asked about the health behaviors members wanted to change and explored their current access to, and potential use of, the Internet to make these changes. Surveys were mailed to 1,368 members, and 521 (38%) were returned. Most respondents (92.5%) had contemplated making one or more health behavior changes in the past year, which included becoming more physically active (94.6%), improving eating habits (86%), losing weight (81%), improving stress management (62%), and reducing tobacco use (46%). Popular sources of health behavior change information used included reading material (95.5%) and the Internet (91.3%). Many respondents had Internet access (82%), and average computer self-efficacy, rated on a scale of 1 to 5, was very high (mean = 4.05, SD = 0.91). Use of the Internet by health professionals to promote health behavior change among Oregon Air National Guard personnel seems feasible and desirable.