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ABSTRACT: African American (AA) women have the highest prevalence of obesity in addition to health disparities in preventable diet-related diseases (i.e., diabetes, hypertension), which places them at increased risk for cardiovascular disease. The purpose of this pilot study was to assess the feasibility, acceptability, and preliminary effectiveness of the Keto Prescribed+ (KetoRx+) program on associated physical and psychosocial outcomes among this population. The KetoRx+ program is a healthy eating and thinking educational intervention. The program combined online and in-person community group sessions over 8 weeks. The Keto Prescribed+ was found to be feasible and acceptable with comments on ways to increase acceptability from participants completing program (n = 10). Physical outcomes changed showed an average decrease in weight of 10lbs (SD = 5), baseline average 226lbs. Waist-to-hip ratio and systolic blood pressure also trended down. Psychosocial outcomes showed improvement trends. The KetoRx+ program is feasible and acceptable for overweight or obese AA women. Preliminary efficacy was established for most physical and psychosocial outcomes. However, more research is needed to identify specific program components contributing to healthy lifestyle behavior change and to establish program efficacy and effectiveness. Culturally adapted community-based biopsychosocial interventions using ketogenic nutrition therapy may help improve cardiovascular health of adult AA women.
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Negro o Afroamericano , Humanos , Femenino , Proyectos Piloto , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Adulto , Persona de Mediana Edad , Obesidad/terapia , Obesidad/psicologíaRESUMEN
Well-documented scientific evidence indicates that mobile health (mHealth) apps can improve the quality of life, relieve symptoms, and restore health for patients. In addition to improving patients' health outcomes, mHealth apps reduce health care use and the cost burdens associated with disease management. Currently, patients and health care providers have a wide variety of choices among commercially available mHealth apps. However, due to the high resource costs and low user adoption of mHealth apps, the cost-benefit relationship remains controversial. When compared to traditional expert-driven approaches, applying human-centered design (HCD) may result in more useable, acceptable, and effective mHealth apps. In this paper, we summarize current HCD practices in mHealth development studies and make recommendations to improve the sustainability of mHealth. These recommendations include consideration of factors regarding culture norms, iterative evaluations on HCD practice, use of novelty in mHealth app, and consideration of privacy and reliability across the entire HCD process. Additionally, we suggest a sociotechnical lens toward HCD practices to promote the sustainability of mHealth apps. Future research should consider standardizing the HCD practice to help mHealth researchers and developers avoid barriers associated with inadequate HCD practices.
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Background: Nearly 70% of faculty experience very high levels of stress. Integrative Nurse Coaching (INC) can help by assisting clients in establishing goals and embarking on new lifestyle behaviors that help to decrease perceived stress, achieve work life integration, and enhance life satisfaction. Our goal was to evaluate a faculty coaching and fellowship program to support faculty well-being while developing innovation competency. Methods: We employed an INC paradigm to coach five faculty to build confidence and competence in innovation and enhance well-being. We offered monthly group and individual coaching and used a qualitative research thematic analysis to determine themes important for the fellow and group experiences, identify outcomes, and create recommendations for the future. Results: We identified the following themes as outcomes for our program: (1) enhanced connection, comradery, and support; (2) increased confidence and competence in navigating academia; (3) shift from a fixed mindset to an innovation mindset; and (4) increased ability to identify and manage stress and burnout. Fellows also experienced a shift from focusing on individual needs to addressing the needs of the community at the college. Conclusion: Nurse coaching is an effective strategy to address faculty stress and burnout. Additional research is needed to evaluate the Innovation for Well-being faculty fellowship program and its impact on the academic community.
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PURPOSE: The purpose of this article is to 1) review updated business competencies in The Essentials: Core Competencies for Professional Nursing Education for Advanced-Level Nursing Education (2021) and 2) suggest strategies on how to integrate business and finance concepts encompassing quality, safety, and systems-based practice into DNP educational curricula. BACKGROUND: The Institute of Medicine recognizes strong nursing leadership on all system levels from "bedside to boardroom" as critical to redesigning healthcare that is affordable and accessible. The business of healthcare requires the DNP-prepared nurse to be equipped to understand and navigate business principles necessary for sustainable change to improve patient outcomes. The updated 2021 AACN Essentials include enhanced business concepts and competencies as curricular elements to prepare practice-ready DNP prepared leaders. FINDINGS: Current healthcare translation of research to practice has historically been slow, and only recently has the average time for research to translate to practice decreased from 17 years to 15 years. DNP-prepared nurses, as evidence-based practice and quality improvement experts, are positioned perfectly to reduce this research translation time gap to improve patient outcomes by implementing evidence-based change. Employers outside the academic setting, and arguably even within the academic setting, often fail to understand this unique skill set of a DNP-prepared nurse. A lack of business expertise disadvantages s the DNP-prepared nurses 'ability to effectively communicate and demonstrate the ROI and value added to an organization or interprofessional team. Achieving competency with business concepts during DNP education such as marketing, budgeting, return on investment, healthcare finance and interprofessional collaboration are critical components for a practice-ready DNP graduate as noted within the revised AACN Essentials (2021). DISCUSSION: The didactic content of business education that meets the 2021 AACN Essentials can be integrated in established DNP core courses or through creating new courses in the curriculum. Students through innovative assignments, immersion experiences, and the DNP final scholarly project can demonstrate application and competence of learned business principles. Strategically integrating business concepts into DNP curriculum provides multiple benefits to the DNP graduate, organizations, and ultimately, patients.
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Educación de Postgrado en Enfermería , Educación en Enfermería , Enfermeras y Enfermeros , Estudiantes de Enfermería , Humanos , Atención a la Salud , CurriculumRESUMEN
BACKGROUND: Cardiovascular disease (CVD) is the number one cause of death in the United States of America and across the world. The high prevalence of obesity (56.9%) in African American women contributes to high rates of CVD. Ketogenic nutritional therapy has been shown to be a safe and effective therapy for weight loss and reduction in other CVD risk factors (e.g., HgbA1C and blood pressure). However, the evidence investigating ketogenic nutritional therapy among African American women to improve CVD risk factors has not yet been synthesized. AIMS: To conduct a systematic review of the evidence on CVD risk reduction and ketogenic nutrition therapy among African American women. METHODS: CINAHL Plus, Cochrane, EMBASE, MEDLINE/PubMed, SCOPUS, and Web of Science were searched for quantitative studies focused on ketogenic nutritional therapy and CVD risk factors among African American women. Included studies measured beta-hydroxybutyrate as an indicator of dietary adherence. RESULTS: Of 4,799 articles identified, six articles representing five studies were included in this review. The majority of participants were female, with very few identified as African American women. Primary outcomes included weight, body mass index (BMI), blood pressure, and lipids. Dietary adherence was difficult to assess. Significant reductions in weight and BMI were noted. Heterogeneity in study design, intervention length, and measurement of dietary adherence made generalizations difficult. Few studies continually monitored dietary adherence using beta-hydroxybutyrate levels, thus threatening the internal validity of the studies. A gap in our understanding remains concerning CVD risk and ketogenic nutritional therapy among African American women specifically. LINKING EVIDENCE TO ACTION: Ketogenic nutritional therapy is effective in women to reduce weight and BMI. Ketogenic nutritional therapy may be beneficial in reducing CVD risk factors. Monitoring dietary adherence using beta-hydroxybutyrate levels with commercially available monitors is key to intervention success.