Health effectiveness of community health workers as a diabetes self-management intervention.

OBJECTIVE: To evaluate the health effectiveness of community health workers among three groups (intervention, attentional control and control groups) of Hispanic adults with uncontrolled (HbA1c >8%) type 2 diabetes mellitus. METHODS: This was a randomized clinical trial involving 180 English- and Spanish-speaking Hispanic individuals with uncontrolled type 2 diabetes mellitus, 40-74 years of age, who received diabetes care at an outpatient, public, urban hospital. Repeated-measures analysis of variance was used to evaluate the effect of time and group on the primary outcome measure and secondary outcomes. Group differences in the percentage of participants achieving at least 1% reduction in HbA1c levels were assessed using chi-square tests. RESULTS: Patients' ages ranged from 44 to 74 years, 40% were male, 97% preferred Spanish and seven Spanish-speaking countries were identified as country of origin. Relative to the control and attentional control groups, the intervention group showed greater HbA1c reduction from baseline to 12 months and was the group with the highest percentage of participants showing 1% or more HbA1c reduction. CONCLUSION: Integration of community health workers improved disease control for patients with type 2 diabetes mellitus during the intervention phase. Peer-driven/interactive ways to sustain diabetes control need to be explored.

Partnership among a faith-based organization and community.

In a collaborative effort, a community-based participatory research approach was used to address the holistic health needs of a community while including a multilanguage view, a faith-based organization, The Legacy Center Community Development Corporation, and several health agencies partnered in organizing and conducting a health fair in West Central Queens. Health awareness and health promotion activities were provided through presentations, health screenings, and education materials (on diabetes, hypertension, nutrition, cholesterol, and heart disease). To meet the needs of community and/or faith-based organization members, translation services were available: nurses translated for non-English-speaking participants in Spanish, Mandarin, or Cantonese, and sign language interpreters used American Sign Language to translate for deaf participants.

Cultural competency in baccalaureate US nursing education: hybrid course.

The ability to appropriately care for diverse populations is an expected competency of the graduated Bachelor of Science in Nursing (BSN). To provide effective materials to ensure this competency is met, the American Association of Colleges of Nursing developed the Toolkit of Resources for Cultural Competent Education for Baccalaureate Nurses. The toolkit provides information on cultural competency models and teaching strategies nurse educators can use to facilitate student learning in cultural sensitivity and competency. This article demonstrates how one model in particular, Campinha-Bacote's Model of Cultural Competence, was utilized for 15 weeks in an undergraduate BSN nursing course for a student population in an urban school of nursing to effectively provide students with the skill set needed to give culturally competent care. This article will provide the methods and strategies used to teach cultural competency as based on Campinha-Bactote's Model in an undergraduate nursing course.

The prevalence of asymptomatic and symptomatic peripheral arterial disease and peripheral arterial disease risk factors in the U.S. population.

The National Health and Nutrition Examination Survey 2003 to 2004 data set was utilized to examine trends and differences of individuals with asymptomatic and symptomatic peripheral arterial disease (PAD) and PAD risk factor variables, determined by Ankle-Brachial Index measurement. A descriptive secondary data analysis was conducted by using the variables age, gender, hypertension (ie, systolic blood pressure and diastolic blood pressure), dyslipidemia (ie, high-density lipoprotein and low-density lipoprotein), diabetes, and cigarette smoking.

A school of nursing-wellness center partnership: creating collaborative practice experiences for undergraduate US senior nursing students.

As there is a global drive for schools of nursing (SONs) to increase enrollments and as there is a strain in the number of placement sites available to nursing students, SONs need to think innovatively about creating new collaborative partnerships that can serve as placement sites. A collaborative US intrainstitutional partnership was developed between an urban college wellness center (WC) and a SON that met the following needs: (1) it provided a community/public health nursing clinical practice site for undergraduate, senior-year baccalaureate SON students and (2) it enhanced and expanded WC services for the college community. During 7-week clinical sessions, nursing students provided holistic nursing care through screenings, health promotion activities, and educational meetings. Having the WC as a clinical site allowed the students to assess, integrate, and synthesize didactic knowledge and critical thinking skills into the clinical setting while providing critically needed holistic nursing services to their college community. Further, the collaboration created an ongoing partnership that bridged the service and academic needs of both entities.

Addressing low-density lipoprotein (LDL) in Mexican Americans with diabetes in the NHANES (1999-2000 and 2001-2002).

The National Health and Nutrition Examination Survey (1999-2000 and 2001-2002) was utilized to examine and compare low-density lipoprotein levels in Mexican Americans with diabetes.

Addressing cultural heterogeneity among Hispanic subgroups by using Campinha-Bacote's model of cultural competency.

Campinha-Bacote's model "The Process of Cultural Competence in Delivery of Health Care Services" is used to describe Hispanic cultural heterogeneity and to guide nurses in providing culturally competent and sensitive holistic care to individuals from different Hispanic subgroups. But for nurses to do so, healthcare organizations also must make the appropriate resources and structural supports available to them.