Productive Struggle: How Community Coalitions Developed Capacity to Conduct Qualitative Research Through CBPR.

There is a lack of evidence as to how the subcomponents of motivation, innovation-specific capacity, and organizational capacity affect community readiness and the implementation of evidenced-based practices. The Strategic Prevention Framework-Partnerships for Success (SPF-PFS) Initiative in Ohio is guided by a collaboration between the Ohio Department of Mental Health and Addiction Services, Ohio's SPF-PFS Evaluation Team, Ohio's Coaching and Mentoring Network, and community coalitions from 10 Appalachian and/or rural communities. To address the goals of the SPF-PFS, we paired an empowerment evaluation framework with a community-based participatory research approach that enabled communities to take complete ownership of local data and research processes. This approach yielded a pedagogical framework in which all 10 community coalitions were able to extend a quantitative needs assessment by examining local conditions contributing to substance use using qualitative research methods. Members of the coalitions became local leaders in conducting qualitative research, which, in turn, enhanced their organizational capacity. Our purpose is to communicate this successful strategy, along with some challenges we encountered, for developing innovation-specific capacity within the participating community coalitions to utilize qualitative research methods in order to obtain information about the local conditions affecting substance misuse. We describe how an empowerment evaluation framework, when paired with community-based participatory research, can also increase organizational capacity by supporting community coalitions as they successfully leveraged new skills related to strategic planning.

The first year: employment patterns and job perceptions of nursing assistants in a rural setting.

AIM: The aim of this study was to follow rural certified nursing assistants (CNAs) (n=123) in the United States for 1 year post-training to identify retention and turnover issues in the long-term care (LTC) setting by exploring the CNAs' perceptions of the LTC work experience. BACKGROUND: Turnover among CNAs impacts the quality of care, imposes a financial burden on facilities and taxpayers, and creates increased stress and workloads on those who remain. METHOD: A longitudinal survey design was used to track individuals completing CNA training for 1 year. RESULTS: At 1 year post-training, 53.7% of respondents currently worked in LTC, 30.9% worked in LTC and left, and the remaining 15.4% never worked in LTC. CONCLUSION: While the training site does not appear to impact retention, the first 6 months of employment appear critical. The CNAs cited pay as a reason for leaving LTC, but better pay did not characterize the jobs taken by the CNAs who left. Implications for nursing management. This study highlights the importance of the first 6 months of employment to retention and provides practical information for nurse managers evaluating the resource-effectiveness of hosting training programmes. Additionally, the key issues influencing retention were identified and practical suggestions for nurse managers to improve retention are provided.

Where is family in the family nurse practitioner program? Results of a U.S. family nurse practitioner program survey.

Though recent progress in family nursing science can serve the family nurse practitioner (FNP) to intervene in the regulation of family health, whether those advances are taught to FNP students has been unclear. All 266 FNP programs in the United States were invited to participate in a survey to assess the content and clinical application of family nursing theories in the curriculum. The majority of FNP programs frame family as the context of care for the individual. Though FNP students receive a foundation in family nursing theory in core courses, they are not usually expected to use family assessment methods in clinical practicum courses or to plan interventions for the family as the unit of care. The authors challenge educators to consider family nursing science as an essential component of the FNP program as the Doctor of Nursing Practice (DNP) evolves and becomes requisite for entry into advanced practice.

With crisis comes opportunity: Unanticipated benefits resulting from pivots to take-home naloxone (THN) programs during the COVID-19 pandemic.

The COVID-19 pandemic resulted in stay-at-home orders, which presented a significant challenge to the design and operation of an essential harm-reduction strategy in the opioid epidemic: community-based, take-home naloxone (THN) programs. This commentary describes how four rural and/or Appalachian communities quickly pivoted their existing THN programs to respond to community need. These pivots, which reflect both the context of each community and the capacities of its service delivery and technology platforms, resulted in enhancements to THN training and distribution that have maintained or expanded the reach of their efforts. Additionally, all four community pivots are both highly sustainable and transferrable to other communities planning to or currently implementing THN training and distribution programs.

Creating Spaces for Young People to Collaborate to Create Community Change: Ohio's Youth-Led Initiative.

Scholars and researchers are increasingly calling attention to the need for community-based coalitions to become more inclusive of local residents and engage those most directly affected by the issues. One population, however, often remains the recipient of services as opposed to partners or leaders in community change initiatives: youth. Over the past several years in Ohio, adults convening and facilitating youth-led programs have been transforming their work by utilizing the Youth Empowerment Conceptual Framework and the Substance Abuse and Mental Health Services Administration's Strategic Prevention Framework to empower young people and ensure their equitable participation in community change efforts. This article provides an overview of Ohio's statewide youth-led initiative, highlighting how adult allies engaged young people in a data-driven strategic planning process and intentionally selected and implemented strategies designed to affect the health of their local communities. This initiative provides key insights into the Collaborating for Equity and Justice Principles 4, 5, and 6.

Predictors of daily blood glucose monitoring in Appalachian Ohio.

OBJECTIVE: To determine factors contributing to successful diabetes self-management in Appalachia, as evidenced by daily blood glucose monitoring. METHODS: A telephone survey (N=3841) was conducted to assess health status and health care access. The current investigation is limited to the subset of this sample who report having diabetes (N=529). RESULTS: A multivariate logistic regression model established that having attended a diabetes education class (P<.01) was the most significant predictor of successful diabetes self-management. The inability to pay for care, demographic variables, and health risk indicators were not found to be significantly related to self-management. CONCLUSIONS: This study identifies the role of education in successful diabetes self-management for patients in the Appalachian region.

Family inclusion in diabetes education: a nationwide survey of diabetes educators.

PURPOSE: The purpose of this study was to investigate perceptions about family inclusion and support in diabetes self-management education. METHODS: Surveys were mailed to certified diabetes educators (CDEs) in all 50 states and the District of Columbia, with a return of 225 surveys. Descriptive and inferential statistics (eg, t test, analysis of variance, correlation, and chi-square) were used as appropriate. RESULTS: Levels of importance placed on family involvement in diabetes education were significantly related to the emphasis placed on family during CDEs' formal or preprofessional education. CDEs' formal exposure to family theory influenced perceptions of their knowledge about family and the frequency that family support was emphasized in self-management activities but was unrelated to perceptions of their skillfulness in educating family members. Diabetes educators' personal values of family support were significantly related to how frequently family members were asked to participate in formal diabetes education classes. CDEs perceived that they were meeting individuals' self-management needs significantly better than those of families. Regional differences did not appear to be a factor in how CDEs incorporated family in diabetes education. CONCLUSIONS: Diabetes educators without formal exposure to family theory may be overestimating how much they emphasize family support in diabetes education. Increasing formal education about the importance of family involvement in self-management behaviors could positively affect individual diabetes self-management outcomes.