Exploring the Interrelationships Between Physical Function, Functional Exercise Capacity, and Exercise Self-Efficacy in Persons Living with HIV.

PURPOSE: To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics. SETTING/SAMPLE: A total of 810 participants across eight sites located in three countries. MEASURES: Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test. ANALYSIS: Both univariate and multivariant analyses were used. RESULTS: Physical function was significantly associated with Making Time for Exercise (ß = 1.76, p = .039) but not with Resisting Relapse (ß = 1.16, p = .168). Age (ß = -1.88, p = .001), being employed (ß = 16.19, p < .001) and race (ßs = 13.84-31.98, p < .001), hip-waist ratio (ß = -2.18, p < .001), and comorbidities (ß = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R2 = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (ß = 0.14, p = .029), and Resisting Relapse scores again did not (ß = -0.10, p = .120). Among the covariates, age (ß = -0.16, p < .001), gender (ß = -0.43, p < .001), education (ß = 0.08, p = .026), and hip-waist ratio (ß = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R2 = .081). We found a modest significant relationship between physical function and functional exercise capacity (r = 0.27). CONCLUSIONS: Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.

Interprofessional Suicide Prevention Education.

The COVID-19 pandemic has raised concerns regarding possible spikes in suicidal behavior in light of heightened risk factors such as social isolation and financial strain; thus, comprehensive suicide prevention training for emerging health service providers is increasingly vital. This article summarizes an interprofessional education (IPE) suicide prevention course delivered in-person in Spring 2020. Pilot data demonstrate that despite the impact of COVID-19 on higher education, this course had long-term impacts on trainee suicide prevention efficacy, IPE attitudes, and use of course content in practice. Discussion serves to address enhancements for interprofessional and suicide prevention education during and after the pandemic. Emphasis is placed on adaptable training strategies, considerations in the delivery format, guidelines for intensive virtual meetings with trainee teams, and future directions in IPE suicide prevention training research.

Educational Model to Increase the Number and Diversity of RN to BSN Graduates From a Resource-Limited Rural Community.

Increasing the number of BSN-prepared nurses at the bedside is directly linked to improved health care outcomes. However, employers are challenged to find enough BSN graduates to meet workforce demands. This article presents an educational model that uses evidence-based practices to increase enrollment, retention, and graduation rates of RN students in a BSN program (RN-BSN) in a resource limited rural community. This exemplar may equip nurse educators with strategies to adopt in their own communities.

Effectiveness of health education teachers and school nurses teaching sexually transmitted infections/human immunodeficiency virus prevention knowledge and skills in high school.

BACKGROUND: We examined the differential impact of a well-established human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) curriculum, Be Proud! Be Responsible!, when taught by school nurses and health education classroom teachers within a high school curricula. METHODS: Group-randomized intervention study of 1357 ninth and tenth grade students in 10 schools. Twenty-seven facilitators (6 nurses, 21 teachers) provided programming; nurse-led classrooms were randomly assigned. RESULTS: Students taught by teachers were more likely to report their instructor to be prepared, comfortable with the material, and challenged them to think about their health than students taught by a school nurse. Both groups reported significant improvements in HIV/STI/condom knowledge immediately following the intervention, compared to controls. Yet, those taught by school nurses reported significant and sustained changes (up to 12 months after intervention) in attitudes, beliefs, and efficacy, whereas those taught by health education teachers reported far fewer changes, with sustained improvement in condom knowledge only. CONCLUSIONS: Both classroom teachers and school nurses are effective in conveying reproductive health information to high school students; however, teaching the technical (eg, condom use) and interpersonal (eg, negotiation) skills needed to reduce high-risk sexual behavior may require a unique set of skills and experiences that health education teachers may not typically have.

Novel interventions for HIV self-management in African American women: a systematic review of mHealth interventions.

The purpose of this systematic review was to assess the quality of interventions using mobile health (mHealth) technology being developed for and trialed with HIV-infected African American (AA) women. We aimed to assess rigor and to ascertain if these interventions have been expanded to include the broad domain of self-management. After an extensive search using the PRISMA approach and reviewing 450 records (411 published studies and 39 ongoing trials at clinicaltrials.gov), we found little completed research that tested mHealth HIV self-management interventions for AA women. At clinicaltrials.gov, we found several mHealth HIV intervention studies designed for women in general, forecasting a promising future. However, most studies were exploratory in nature and focused on a single narrow outcome, such as medication adherence. Given that cultural adaptation is the key to successfully implementing any effective self-management intervention, culturally relevant, gender-specific mHealth interventions focusing on HIV-infected AA women are warranted for the future.

Impact of a quality improvement intervention on provider adherence to recommended standards of care for adults with type 2 diabetes mellitus.

PURPOSE: To report provider adherence to standards of care for adults with type 2 diabetes before and after a quality improvement (QI) intervention. DATA SOURCES: Pre- and post intervention data were abstracted from 50 medical records of patients with type 2 diabetes in a small primary care practice. CONCLUSION: There was a significant increase in the rates of foot and urine microalbumin screenings, documentation for dilated eye exams were not statistically significant. These findings demonstrated the effectiveness of using simple practice aids to reinforce adherence to the standards of care in diabetes. The failure to see a corresponding improvement in glycemic and blood pressure control is consistent with prior research and the need for more research in this area remain critical. IMPLICATIONS FOR PRACTICE: Ethnic minorities are more likely to have worse control of their diabetes and more likely to receive all their care in the primary care setting, QI interventions targeting primary care providers have the potential to reduce disparities in diabetes care. Future research to determine whether cultural tailoring of diabetes QI interventions will produce additional benefits above those of generic diabetes QI interventions are needed.

A pilot study using electronic communication in home healthcare: implications on parental well-being and satisfaction caring for medically fragile children.

The aim of this study was to explore the impact of a nurse-established and nurse-managed electronic communication in the form of e-mail on the self-reported well-being and satisfaction of parent's caring for medically fragile and technologically dependent children. This study was conducted in a pediatric home care agency located in the southeastern region of the United States. Nineteen parents and caregivers participated in a 3-month intervention. A quasiexperimental pre- and posttest design was used. There were no significant differences in pre- and postintervention parental self-reported well-being (p < .227) or satisfaction (p < .528). Parental qualitative comments suggest positive outcomes related to well-being and satisfaction. Further investigation into the utility of e-mail communication with parents of medically fragile and technologically dependent children cared for at home is warranted.

When intimate partner violence against women and HIV collide: challenges for healthcare assessment and intervention.

UNLABELLED: Intimate Partner Violence (IPV) and Human Immunodeficiency Virus (HIV) both constitute major public health issues that impact the overall health of women. IPV, including sexual assault, remains a persistent public health concern that has proven to be both difficult and significantly dangerous to prevent and treat. Based on data from UNAIDS more than 14.5 million women were living with HIV by the end of 2005. IPV and HIV are often interrelated. Exposure to IPV has been associated with an increased risk for contracting HIV and women who are living with HIV may be more likely to become victims of IPV. IMPLICATIONS: comprehensive care and services have to be offered in the context of where women seek health care. Screening and effective intervention for IPV are essential components of HIV-related services including prevention programming, voluntary counseling and testing, and treatment. Including IPV-related services into the context of HIV-related services delivers the message that violence is not a taboo topic in the health-care setting.

Self-care behaviors of African American women living with HIV: a qualitative perspective.

Significant numbers of African American (AA) women have been diagnosed with HIV over the past decade. HIV may be viewed as a chronic condition that can be actively managed through the use of self-care behaviors, yet little is known about how these women define self-care (SC) for themselves, and still less is known about what facilitates and hinders SC behaviors among these women. This article highlights the results of a qualitative research study undertaken with AA women living with HIV in a metropolitan city in the southeastern United States. The objective of this study was to systematically collect data about the SC experiences of these women. Focus group methodology was used. Content analysis of the data was conducted. Two primary domains emerged: do what the doctor says and living healthy. SC activities included seeking social support, managing disclosure, engaging in pampering, taking part in religious customs, and maintaining recovery.

Disconnects between news framing and parental discourse concerning the state-mandated HPV vaccine: implications for dialogic health communication and health literacy.

In 2007, Virginia became the first state in the US to mandate the human papillomavirus (HPV) vaccine. In 2009, the mandate required that parents of girls entering sixth grade (ages 11-12) vaccinate their daughters or sign the 'opt-out' waiver. This investigation is the first to explore how both the news media and parents framed and responded to the newly-mandated HPV vaccine. This research reveals disjoints between news media framing and parental framing. Implications of these gaps for parental healthcare decision-making are addressed and suggestions are offered for constructing a more dialogic, community-based approach that can increase health literacy regarding the HPV vaccine.

Integrating intimate partner violence content across curricula: Developing a new generation of nurse educators.

Abuse between intimate partners can take many forms. Prevalence data analyses confirm that intimate partner violence (IPV) is a widespread problem. Meeting the objectives of World Health Organization's "Global Campaign on Violence Prevention" will involve many organizations and institutions within and beyond the health care community. Educating prospective Nurse Educators about IPV does, however, present challenges, as most nurses lack awareness of IPV as a public health problem, have limited knowledge and erroneous beliefs about IPV, and are inexperienced in caring for survivors of IPV. Thus providing formal education and training in a supportive environment will enhance Nurse Educators' knowledge and skills about IPV while helping them to examine the benefits and limitations of various pedagogical approaches for teaching this critical content to students. Hence targeting educational efforts at nurses who are pursuing the academic role is an important first step toward raising the collective consciousness of nurses to the point that IPV education becomes an integral component of the nursing curriculum, and competence in caring for IPV survivors becomes the standard rather than the exception.