Telenovela (Spanish Soap Opera) Interventions on Latino Health: A Scoping Review.

Introduction: The use of telenovelas shows promise as a mode of education that could enhance Latino people's ability to prevent or manage different health conditions. This scoping review examined the available evidence about telenovela interventions on Latino health. Methods: A scoping review was conducted by searching five peer-reviewed databases for articles published on any date in English or Spanish. The methods of this review were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews recommendations. Results: A total of 431 articles were identified, and 22 articles published between 1999 and 2022 were included in the final scoping review. Nineteen telenovela interventions were described in the literature. Most studies included telenovela interventions without other elements (n = 15; 68%), and 91% were conducted in the U.S. (n = 20). Studies were qualitative (n = 8; 36%), quantitative (n = 8; 36%), and mixed methods (n = 6; 27%), and most telenovela interventions were developed and/or tested in Spanish (n = 10; 53%). The most common topics for the telenovela interventions were substance use/risky sexual health behaviors, cardiovascular disease, and mental health. Conclusions: This scoping review may serve to continue empirical and theoretical work on telenovela-style entertainment interventions on Latino health and future implementation in real-life settings.

Predictors of Human Papillomavirus Vaccine Intention and Uptake Among US Hispanic Parents: A Cross-Sectional Study.

Introduction: This study explored the influence of the Theory of Planned Behavior constructs on human papillomavirus (HPV) vaccine (HPVV) intentions and uptake among Hispanic parents in South Florida for their children aged 9-21. Method: A descriptive exploratory analysis was conducted using 39 surveys completed by Hispanic parents. These surveys encompassed demographic data and questions about HPVV uptake, intention, attitudes, subjective norms, knowledge, self-efficacy, and awareness. Results: Most participants were uninsured (77%), unemployed (59%), and had low Americanism acculturation (74%). A little over half were aware of the HPVV (54%), yet most had high positive HPVV attitudes (95%) and self-efficacy (85%). HPVV intentions within the year were also high (82%); however, HPVV uptake (45%) and HPVV knowledge (40%) were low at the time of the study. Most parents reported physicians (72%) and nurses/nurse practitioners (59%) as the most influential individuals in their decision-making. A statistically significant relationship between HPVV intention and HPVV attitude (X_Wald^2 (1) = 5.71, p = 0.02., OR = 5.11) and between HPVV uptake and HPVV awareness (X_Wald^2 (1) = 4.63, p = 0.03., OR = 12) were observed. Conclusion: This study recommends further research and targeted interventions to improve HPVV awareness among Hispanic communities. The participants' highly positive attitudes and self-efficacy provide a hopeful outlook for future vaccination efforts within this demographic.

Feasibility and acceptability of SEPA+PrEP: An HIV prevention intervention to increase PrEP knowledge, initiation, and persistence among cisgender heterosexual Hispanic women.

The HIV epidemic disproportionately affects Hispanics in the U.S., with Hispanic women (HW) accounting for 18% of new HIV diagnoses in 2019 despite comprising only 16% of the female population. The imbalance of power related to cultural values and HW's lack of knowledge and low perception of risk for HIV interferes with prevention efforts (e.g., condom use, HIV testing, and Pre-Exposure Prophylaxis [PrEP]). It is estimated that in 2019, only 10% of women in the U.S. who could benefit from PrEP were given prescriptions for it. This number is estimated to be significantly lower among HW. PrEP is highly effective for preventing HIV, reducing the risk of acquiring HIV from sexual activity by about 99%. To respond to this need, we developed SEPA+PrEP, a biobehavioral HIV prevention intervention that adapted and integrated SEPA (Salud/Health, Educación/Education, Prevención/Prevention, Autocuidado/Self-Care), an empirically validated behavioral HIV prevention intervention, with the evidence-based biomedical strategy of PrEP. This study aimed to investigate the feasibility and acceptability of SEPA+PrEP among cisgender heterosexual Hispanic women (HW). We used a mixed methods approach to gather data from 44 HW living in the City of Homestead and its surrounding communities in Miami-Dade County, Florida. None of the participants knew about PrEP prior to participating in the study, and the majority (70.5%, n = 23) had not used condoms when engaging in vaginal sex during the previous three months. Overall, study results suggest that SEPA+PrEP is an acceptable and feasible intervention to prevent HIV among HW, with a focus on PrEP knowledge, initiation, and maintenance.

Bearing (Aguantando) With Intimate Partner Violence: A Grounded Theory Study of Self-Silencing Among Hispanic Women Who Experienced Intimate Partner Violence.

Hispanic women who experience intimate partner violence (IPV) face unique disparities. They have poorer health outcomes and are less likely to seek help than their non-Hispanic counterparts. When women remain in relationships where IPV occurs and refuse to disclose or seek treatment, they may resort to self-silencing, which can also worsen health outcomes. The purpose of this study was to develop a theory that explains how self-silencing evolves among Hispanic women who experience IPV. Participants were recruited from two research studies focused on Hispanic women's health, and from snowball sampling, which involved referrals by previously registered participants. Data were collected via Zoom® and included individual interviews. A total of 25 women participated in this study. Analysis followed constructive grounded theory levels of analysis described by Charmaz and constant comparative methods described by Glaser and Strauss. A grounded theory entitled Bearing (Aguantando) With Intimate Partner Violence emerged from the data. The theory explains the main strategy Hispanic women use to deal with violence while remaining in a relationship where IPV occurs. The theory is constructed of four categories with subcategories. The results of this study provide an initial framework to understand the self-silencing process among Hispanic women who experience IPV. In addition, this study identifies different levels of interventions that can be useful for researchers and healthcare providers to promote Hispanic women's ability to become empowered, use their voices, and seek help.

Infección de Amor (Infectious Love): Development and Acceptability of a Telenovela/Soap Opera Intervention for HIV Prevention For Latinas.

Latinas continue to be disproportionately affected by HIV in the United States. Effective interventions to address HIV-related disparities among Latinas are available; however, they have not achieved widespread dissemination due to implementation challenges for real-world settings. A culturally tailored intervention that increases access to HIV prevention is urgently needed. The objective of this study was to develop a culturally tailored telenovela (i.e., a soap opera) to promote HIV prevention behaviors (condom use; HIV testing; and pre-exposure prophylaxis awareness, access, and use) among Latinas. The study was conducted in community organizations throughout South Florida. A total of 44 Spanish-speaking Latinas, 18-35 years old, and sexually active with a man in the past 6 months participated in the study. The final product was an HIV prevention telenovela that incorporated Latinas' ideas and feedback and was produced as four 10-minute filmed episodes. This study aimed to develop innovative approaches to reduce HIV-related disparities for Latinas.

Sources of Well-Being for Hispanic Women Who Have Experienced Intimate Partner Violence: A Scoping Review.

Purpose: This review sought to identify and integrate available evidence on various sources of Hispanic women's well-being following intimate partner violence (IPV). Methods: The review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Four peer-reviewed databases were reviewed for studies published between 2007 and 2022. The inclusion criteria include being an original research, quantitative and/or qualitative data, Hispanic women as a separate group for analysis, well-being as an outcome variable (quantitative) or phenomenon of interest (qualitative), and published in English or Spanish. Results: A total of 2,292 records were identified, and nine articles were included in the final review. Findings revealed that ensuring safety and opportunities for women's children, separating from violent partners, and obtaining a job were related to increased well-being. Other findings revealed that peer support, self-empowerment, and leadership skills were associated with interpersonal, psychological, and community well-being, respectively. Economic and occupational well-being was linked to education and financial independence. Conclusions: This scoping review advances the exploration of well-being among Hispanic women who have experienced IPV. This knowledge can be used to inform post-IPV support for Hispanic women and highlight areas for intervention development to promote well-being.

HIV-Related Stigma and Multidimensional Frailty Among Older Latinos With HIV.

Introduction: Frailty is a geriatric syndrome of increased vulnerability to stressors marked by a higher risk for poor health outcomes. HIV-related stigma is a stressor for Latino people with HIV (PWH) and an important barrier to HIV care. This study examines the association between HIV-related stigma and multidimensional frailty among older Latino PWH. Methods: A cross-sectional design with 120 Latino PWH aged 50 and older was used. Self-reported questionnaires were administered to assess multidimensional frailty (Tilburg Frailty Indicator) and HIV-related stigma (HIV stigma scale). Results: Participants were 59.1 ± 7.0 years old, primarily White-Hispanic (85.00%, n = 102), single (48.33%, n = 58), and male (73.30%, n = 88). Nearly half of the participants were frail (45.85%, n = 55). Compared to non-frail, frail individuals had significantly higher scores in the total HIV-related stigma (M = 98.5 ± 24.7 vs. M = 85.3 ± 25.6, p = .020) and all subscales. The odds of multidimensional frailty were 1.021 times higher for people with higher HIV-related stigma scores (p = .007). This association remained significant after adjustment for income and comorbidities (p = .049). Conclusions: HIV-related stigma among older Latino PWH was significantly associated with their odds of being frail. Efforts to prevent multidimensional frailty should consider addressing HIV-related stigma through age-appropriate and culturally tailored resources for this group.

"ActuaYa": A Preliminary Efficacy Study of a Chronic Disease Prevention and Health Promotion Intervention for Older Hispanic Women.

Chronic diseases (CDs) are increasingly common among the aging population. Some evidence suggests that older Hispanic women ages 50 years and older (OHW) are at an increased risk for CDs and poorer outcomes than other groups. This study investigated the preliminary efficacy of ActuaYa, a culturally tailored CD prevention and health promotion intervention for OHW. A prospective, single-group, repeated measures study (n = 50) was conducted in Florida. Clinical measures and surveys were collected at baseline and post-intervention at 3- and 6-month follow-up. Descriptive statistics, paired-sample t-tests, and McNemar tests were used for analysis. At baseline, more than half of the participants had a CD. Post-intervention results showed a significant decrease in participants' MAP, BMI, and A1C, and a significant increase in self-efficacy for exercise and HIV knowledge compared to baseline measures. The results of this study support the preliminary efficacy of ActuaYa in preventing CDs and increasing health promotion among OHW.

Biopsychosocial Factors of Depression Among Hispanic Women Aged ≥50 Years.

The purpose of the current study was to identify biopsychosocial factors associated with depressive symptoms among Hispanic women aged ≥50 years. Cross-sectional data related to 10 biological, psychological, and social factors were analyzed. Center for Epidemiologic Studies Depression Scale scores suggested that 32% of the sample had depressive symptoms. Self-esteem, self-perception of health status, income, and chronic pain had statistically significant associations with depressive symptoms. A logistic regression analysis showed that increasing self-esteem scores were associated with decreases in the likelihood of having depressive symptoms. Findings underscore that depression is associated with biological, psychological, and social factors. Culturally tailored interventions that aim at targeting these factors may have an impact on Hispanic women's depression and overall well-being. [Journal of Psychosocial Nursing and Mental Health Services, 61(11), 32-42.].

Acceptability, Suitability, and Feasibility of an Evidence-Based Intervention to Reduce HIV Risk Behaviors: Engaging Comadronas in HIV Prevention in Rural Guatemala.

This study addresses rural Guatemala's poor maternal health and HIV status by culturally adapting an evidence-based HIV intervention, SEPA (Self-Care, Education, Prevention, Self-Care), to extend the capacity of comadronas (Mayan birth attendants) as HIV prevention providers. This mixed-method study examined the acceptability, suitability, and feasibility of SEPA presented to traditional elder and a younger cohort of comadronas over three sessions. Outcome variables were reported as mean scores. Open-ended qualitative responses were categorized under central themes. Session 1, 2, and 3 acceptability (4.6/5, 4.6/5, 4.8/5), suitability (4.7/5, 4.6/5, 4.9/5), and feasibility (4.4/5, 4.7/5, 4.8/5) remained high across sessions. While comadronas reported that information was difficult, they reported high levels of understanding and comfort with SEPA content and they also found it to be culturally appropriate, increasing their confidence to discuss HIV with their community. The broader utilization of comadronas could create a pathway to enhance reproductive health among indigenous women.

Assessment of miscarriage factors among Latinas who live in the U.S.: a cross-sectional study.

Introduction: Latinas in the US are underrepresented in miscarriage research, yet face several risk factors for having a miscarriage, including intimate partner violence, and increasing maternal age. Increased acculturation is associated to increased risk of intimate partner violence and adverse pregnancy outcomes among Latinas yet is also understudied in the realm of miscarriage. Thus, this study aimed to analyze and compare sociodemographic characteristics, health-related factors, intimate partner violence, and acculturation among Latinas with and without a history of miscarriage. Methods: This study utilizes a cross-sectional design to analyze baseline data from a randomized clinical trial on the effectiveness of "Salud/Health, Educación/Education, Promoción/Promotion, y/and Autocuidado/Self-care" (SEPA), a human immunodeficiency virus risk reduction intervention for Latinas. Survey interviews were conducted in a private room at the University of Miami Hospital. Survey data analyzed include demographics, a bi-dimensional acculturation scale, a health and sexual health survey, and the hurt, insult, threaten, and scream tool. This study's sample was 296 Latinas, 18 to 50 years old, with and without a history of miscarriage. Data analyses included descriptive statistics, t-tests for continuous variables, negative binomial for counts, and chi-square for dichotomous or categorical variables. Results: Most Latinas were Cuban (53%), lived in the U.S. an average of 8.4 years, had 13.7 years of education, and a monthly family income of $1,683.56. Latinas with history of miscarriage were significantly older, had more children, more pregnancies, and poorer self-rated health than Latinas without history of miscarriage. Although not significant, a high percentage of intimate partner violence (40%) and low levels of acculturation were reported. Discussion: This study contributes new data about different characteristics of Latinas who have and have not experienced a miscarriage. Results can help identify Latinas at risk for miscarriage or its adverse-related outcomes and help develop public health policies focusing on preventing and managing miscarriage among Latinas. Further research is warranted to determine the role of intimate partner violence, acculturation, and self-rated health perceptions among Latinas who experience miscarriage. Certified nurse midwives are encouraged to provide Latinas with culturally tailored education on the importance of early prenatal care for optimal pregnancy outcomes.

Family-based psychosocial interventions for adult Latino patients with cancer and their caregivers: A systematic review.

Objective: This review aimed to systematically examine the characteristics and outcomes of family-based psychosocial interventions offered to adult Latino patients with cancer and their caregivers. Methods: We searched six databases from their inception dates through June 2022. Studies were eligible for inclusion if they (1) targeted both adult Latino patients diagnosed with cancer and their adult caregivers or reported subgroup analyses of Latino patients and caregivers; (2) included family-based psychosocial interventions; (3) used randomized controlled trial (RCT) or quasi-experimental designs; and (4) were published in English, Spanish or Portuguese. Members of our multidisciplinary team assessed the risk of bias in the reviewed studies using the Cochrane Collaboration's Risk of Bias Tool. Results: Our database searches yielded five studies. The studies were conducted in the U.S. and Brazil. Three studies were RCTs, and two used quasi-experimental designs. The sample sizes ranged from 18 to 230 patient-caregiver dyads. These studies culturally adapted the intervention contents and implementation methods and involved bilingual interventionists. The interventions had beneficial effects on multiple aspects of psychosocial outcomes for both patients and caregivers. We also identified methodological limitations in the reviewed studies. Conclusions: Findings from this systematic review help deepen our understanding of family-based psychosocial interventions for Latinos affected by cancer. The small number of psychosocial interventions focused on adult Latino cancer patients and their caregivers is concerning, considering that Latino populations are disproportionally burdened by cancer. Future research needs to design and evaluate culturally-appropriate interventions to support Latino patients and families who cope with cancer. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=274993, identifier CRD42021274993.

Disparities in Resource Availability, Psychological Intimate Partner Violence, and Depression Among Hispanic Women.

This study aims to analyze the relationship between the availability of resources, exposure to psychological intimate partner violence (P-IPV), and depression in Hispanic women in South Florida. This secondary data analysis used cross-sectional baseline data from SEPA (Salud, Educación, Prevención y Autocuidado) III. SEPA III was a randomized controlled trial that tested the SEPA intervention with 320 cisgender, sexually active Hispanic women. Descriptive analysis, logistic, and multiple regressions were conducted. Lower sexual relationship power and attending religious services were associated with higher odds of P-IPV. Reporting a history of P-IPV in the last 3 months predicted depression scores and higher depression scores were associated with higher odds of experiencing P-IPV. Participants with higher depressive scores reported less education, increased emergency room utilization, and less sexual relationship power. P-IPV is highly prevalent among Hispanic women living in South Florida. The availability of personal and community resources can buffer the risk of P-IPV and its mental health consequences. Nurses can strengthen women's resources to prevent Hispanic women from exposure to P-IPV.

Exploring the Psychosocial Impact of Living With HIV on Minority Older Women.

BACKGROUND: Among older adults, minority older women will account for 60% of the new HIV diagnoses. The psychosocial impact of living with HIV among this vulnerable population narrated by their own voices has been understudied. AIMS: The purpose of this study was to explore the psychosocial impact of living with HIV on minority older women. METHODS: In-depth interviews were conducted with 28 minority older women living with HIV at an Ambulatory Care Center HIV Clinic in South Florida. All interviews were audio-recorded and transcribed verbatim. Conventional content analysis was used to identify and define the major themes that emerged from the interviews. Questions included those concerning description of life after the HIV diagnosis, most challenging aspects of life after the diagnosis, and daily activities since the diagnosis. RESULTS: The analysis of the interview data led to five main themes: (I) Social Impact of HIV, (II) Threats to Health and Well-Being, (III) HIV as a Death Sentence, (IV) Spirituality, and (V) HIV Treatment Adherence. In their narratives, women described a myriad of psychosocial issues such as depressed mood, isolation, economic challenges, stigma, anhedonia of interest, fear of death, among others. CONCLUSIONS: There is a compelling empirical need for rapid implementation of a culturally tailored, holistic, low-cost, multistrategy intervention to early screen and reduce the psychosocial impact of HIV among minority older women.

Factors Associated With Psychosocial Illness Impact Among Black/African American and Hispanic Older Women Living With HIV.

BACKGROUND: In 2018, one in six newly diagnosed individuals with HIV in the United States were adults aged 50 years and older, 24% were women, and 60% were Black/African American and Hispanic (42% and 18%, respectively). OBJECTIVES: This study aims to examine the factors associated with HIV psychosocial illness impact among Black/African American and Hispanic older women living with HIV. METHOD: Guided by the socioecological model, a secondary data analysis design with cross-sectional data that included 138 Black/African American and Hispanic women aged 50 years and older was conducted. RESULTS: Higher levels of avoidant coping, depressive symptoms, negative self-perception of health, and decreased social support were significant factors associated with HIV psychosocial illness impact among this sample. CONCLUSIONS: Findings from this study can contribute to identifying solutions to prevent and decrease these negative factors associated with HIV psychosocial illness impact among Black/African American and Hispanic older women.

Development and evaluation of a telehealth-based simulation to improve breastfeeding education and skills among nursing students.

AIM: The aim of this study was to evaluate undergraduate nursing students' perceptions of using telehealth-based simulations for practicing their breastfeeding education skills. BACKGROUND: Telehealth can help bridge the gap between the high need for healthcare services and the limited access to these services, such as breastfeeding mothers in rural settings. However current literature suggests that there is lack of telehealth education among healthcare providers, as well as, a shortage of adequately trained nurses on breastfeeding, making it difficult to provide new mothers with the support they need to successfully breastfeed. Telehealth simulation has shown to be acceptable and helpful in teaching clinical reasoning, increasing exposure to telehealth experiences, and preparing nursing students for real interaction experiences with patients. DESIGN: For this cross-sectional descriptive study, two breastfeeding telehealth simulation scenarios were developed and delivered through Zoom for Bachelor of Science in Nursing students in a high-level institution in Florida. Selected students interacted over Zoom as healthcare providers with a female simulated patient who played as a mother with a breastfeeding concern. Students in their role of healthcare providers assessed the breastfeeding needs of the mother and conducted breastfeeding education as appropriate. After debriefing, students received feedback from faculty and students who observed the simulation and completed an optional evaluation about their telehealth simulated experience. RESULTS: A total of 205 students completed the evaluation. Most students (n = 136, 66.3%) were not familiar with telehealth prior to the simulation. Most students (n = 199, 97.1%) also found the simulation helpful for supporting breastfeeding mothers and wanted more telehealth simulations in the future (n = 162, 79%). Feedback for improving the simulations included: improving the technical setup (n = 17, 8.3%), increasing the time that students interacted with the mother (n = 16, 7.8%), and observing the correct performance of the simulation after debriefing (n = 16, 7.8%). CONCLUSION: Telehealth simulation is a promising modality for clinical competency assessment, thus it is essential to integrate telehealth education into nursing curriculum. It is evident that telehealth-based breastfeeding simulations can be used to address the exposure/knowledge gap among nursing students who are missing or have limited exposure to breastfeeding content and telehealth use in their nursing curriculum.

Preferred HPV and HPV Vaccine Learning Methods to Guide Future HPV Prevention Interventions Among Rural Hispanics.

PURPOSE: HPV vaccination among United States's rural Hispanic youth is suboptimal to the Healthy People 2030 goal. Rural Hispanic parents' HPV vaccine (HPVV) perceptions have influenced these low rates. Furthermore, few effective interventions for increasing HPV vaccination among rural Hispanic populations exist. This study aimed to determine rural Hispanic parent's preferred HPV and HPVV learning methods to guide future HPV prevention interventions. DESIGN AND METHODS: A descriptive qualitative design was used. A total of 23 rural Hispanic parents from South Florida participated in four focus groups. Conventional content analysis was used to analyze the transcripts. RESULTS: Three overcharging themes were identified: 1) Learning method preferences for parents, 2) Learning method preferences for youth, and 3) Learning method preferences for families. Sub-themes included participants' preferences on their interest for an intervention, target audiences, teaching methods, availability of community members, intervention facilitators, and content. CONCLUSIONS: Addressing HPV vaccination by developing culturally tailored programs for rural Hispanic parents is urgently needed to prevent HPV and HPV-related cancers among this disproportionately affected population. Findings highlight essential elements that should be considered when designing an intervention for increasing HPV vaccination among Hispanics in rural settings. PRACTICE IMPLICATIONS: Pediatric nurses must offer culturally appropriate HPVV education and literature and proactively recommend the HPVV at every opportunity. Pediatric nurses can administer the HPVV at schools and community health fairs while clinics can play educational clips in waiting and examination rooms.

Exploring Intimate Partner Relationships before and after HIV Diagnosis among Minority Older Women.

OBJECTIVES: Literature shows that sexual activity remains important at older age and is a valued part of life. However, little is known about the intimate partner relationships (IPR) among minority older women living with Human Immunodeficiency Virus (HIV). The purpose of this study is to explore the effect HIV diagnosis had on the intimate partner relationships (IPR) among minority older women living with HIV (MOWH). METHODS: Qualitative descriptive study. A total of 28 MOWH (Black and Latinas) aged 50 years and older participated in face to face semi-structured in-depth interviews. Interviews were analyzed using content analysis. RESULTS: Three themes emerged from the analysis: (a)"Intimate partner relationships before HIV diagnosis" that revealed sexual practices increasing the risk for HIV in their intimate relationships; (b)"Facing relationship consequences of HIV disclosure after diagnosis" explored the consequences of HIV disclosure, and how disclosure determined the future of their intimate relationships; and (c) "Intimate partner relationships after HIV diagnosis" described the quality of intimate partner relationships and changes after HIV diagnosis. CONCLUSIONS: Results from this study contribute to understanding and increasing awareness of the effect of HIV on the intimacy of MOWH. CLINICAL IMPLICATIONS: Education provided by health care workers and interventions targeting MOWH should address the effect of HIV in IPR, address MOWH's concerns about it, and help them to improve their overall health.

Motivation for Critical Thinking in Nursing Students in Chile.

Nursing education includes a constant challenge regarding the competencies that nurses must possess to provide high-quality nursing care. One of these competencies is critical thinking (CT), and motivation for critical thinking (MCT) has been identified as an element necessary to develop CT. Expectancy and value are important components of the MCT. This study aimed to analyze sociodemographic and academic factors related to MCT in Chilean nursing students. This study is an analytical-correlational, cross-sectional study conducted with 478 nursing students in Chile. The data were collected using an online questionnaire. The Critical Thinking Motivation Scale was used to measure MCT. Pearson's square, Chi-square, means comparison test, and binomial logistic regression were used to analyze the data. The expectancy component of the MCT had the lowest scores on the scale. Age was associated with the cost subcomponent (p < .03), and high school was associated with the interest subcomponent (p < .01). Academic factors contributing to MCT were problem-based learning, professor motivation, and the inclusion of MCT in nursing disciplinary subjects. Strategies that improve CT and MCT should be implemented and evaluated periodically from the beginning of a nursing career. Faculty should be trained to motivate students to think critically.

Predictors of End of Life Discussions Among Minority Older Women Living With HIV Infection.

BACKGROUND: Among the 39,782 newly HIV diagnosed individuals in the U.S., 17% were aged 50+. Although premature aging, morbidity, and mortality are issues for older people living with HIV that threaten their quality of life, less attention has been focused on end of life (EOL) discussions. OBJECTIVES: To examine predictors of EOL discussions with significant others, family members, and friends. METHODS: Cross-sectional design was used for this study guided by the The Socio Ecological Model (SEM). Sample: 119 Black and 19 Hispanic women aged 50+ living with HIV. RESULTS: Predictors of EOL discussions were education, living with a partner, religiosity, and pain, which were at the individual-intrapersonal level of the SEM. DISCUSSION: Findings from this study have important implications for health policy makers and clinicians because they cast a bright light on the substantial continued effort that is needed to improve EOL discussions. .