Exploring the Experiences, Challenges, and Approaches of Parish Nurses in Their Community Practice.

PURPOSE: To explore the personal experiences, challenges, and practices of parish nurses in their communities. METHOD/DESIGN: The overall study used a mixed methods concurrent embedded design to describe parish nurses' experiences with diabetes education and preconception counseling in their practice. Also included were descriptions of generalized practices. Therefore, this current report will focus on these broader experiences. Focus group data were collected using face-to-face, teleconference, and video conferencing formats with 48 nurses who consider themselves to be parish nurses and analyzed with content analysis. FINDINGS: Four qualitative themes were identified in the data: (1) Gaining Entry Through Trust, (2) Enhanced Focus on Spiritual Caring, (3) Accomplishing Much Despite Challenges, and (4) Practice Making a Difference. Parish nurses are uniquely situated to provide holistic care for the mind, body, and spirit of their patients. Despite the many positive aspects, parish nurses experience unique challenges, such as funding their practice and working independently. CONCLUSIONS: The parish nurses can play a vital role in providing holistic care to patients in a faith-based community. Future work is needed to address the challenges of parish nurses such as access to continuing education programs related to health topics of concern to their community members.

Promoting Healthy Eating Among African-American School-Aged Girls in a Community Setting.

The prevention of obesity is vital to the health of American children. In the urban African-American community, the health of school-aged children is in particular jeopardy due to the high prevalence of obesity, type 2 diabetes, and poor dietary choices such as the purchase of sugary drinks, salty snacks, low consumption of fresh fruits and vegetables, and reliance on fast food meals. African-American girls are at a higher risk for obesity and early puberty before age 10, placing them at a greater risk for diabetes and cardiovascular disease in adulthood. Our current "Cooking with Kids" program in a local grocery store has allowed us to promote healthy eating behavior in a unique way; teaching 6 through 11-year-olds how to prepare easy healthy breakfasts, lunches, and snack food recipes at a local grocery store while their mothers shopped.

Experiences of Parish Nurses in Providing Diabetes Education and Preconception Counseling to Women With Diabetes.

OBJECTIVE: To explore the role and experiences of the parish nurse in providing diabetes education and preconception counseling to women with diabetes. DESIGN: Mixed-methods concurrent embedded design. SETTING: Focus groups of community-based parish nurses accessed from a regional database (Pennsylvania, Florida, Ohio, New York, Arizona, and Minnesota). PARTICIPANTS: Forty-eight parish nurses recruited from the Parish Nurse and Health Ministry Program database in Western Pennsylvania. METHODS: The primary method was focus groups using face-to-face, teleconference, and videoconferencing formats. A secondary method used a quantitative descriptive design with three self-report measures (demographic, preconception counseling self-efficacy, and preconception counseling knowledge). Qualitative content analysis techniques were conducted and combined with descriptive analysis. RESULTS: Forty-eight parish nurses participated in 1 of 11 focus groups. Eight qualitative themes emerged: Awareness, Experience, Formal Training, Usefulness, Willingness, Confidence, "Wise Women," and Preconception Counseling Tool for Patients. Participants provided recommendations for training and resources to increase their knowledge and skills. Parish nurses' knowledge scores were low (mean = 66%, range = 40%-100%) with only moderate levels of self-efficacy (mean = 99, range = 27-164). Self-efficacy had a significantly positive association with knowledge (r = .29, p = .05). CONCLUSION: Quantitative results were consistent with participants' qualitative statements. Parish nurses were unaware of preconception counseling and lacked knowledge and teaching self-efficacy as it related to preconception counseling and diabetes education. Understanding parish nurses' experiences with women with diabetes and identifying their needs to provide education and preconception counseling will help tailor training interventions that could affect maternal and fetal outcomes.

Spirituality moderates the relationship of psychosocial stress to metabolic risk factors among Afro-Caribbean immigrants in the US Virgin Islands.

OBJECTIVE: Spirituality may contribute to the health advantage of foreign-born blacks compared to United States (US)-born blacks. The objective of this study was to test the hypothesis that spirituality attenuates the association of psychosocial stress to stress-associated metabolic risk factors among foreign-born Caribbean blacks living in a US jurisdiction. METHODS: Data on demographic factors, anthropometric measurements (height, weight and waist), fasting glucose and insulin, lifestyle behaviors (smoking and alcohol use), psychosocial stress and spirituality were collected from a population-based sample of 319 Afro-Caribbean immigrants, ages 20 and older, who were recruited between 1995 and 2000 in the Virgin Islands of the United States (USVI). Glucose and insulin measurements were used to estimate insulin resistance by the homeostasis model assessment (HOMA-IR) method. Participants were classified into three levels of spirituality, "low", "medium" and "high" based on the distribution of spirituality scores. Stepwise regression analyses were used to identify the significant predictors of waist circumference and HOMA-IR within each level of spirituality. RESULTS: The predictors of waist circumference and HOMA-IR varied across the levels of spirituality. Psychosocial stress was an independent predictor of waist and HOMA-IR only among participants with a low level of spirituality. CONCLUSION: Spirituality appears to attenuate the association of psychosocial stress to waist circumference and insulin resistance among Afro-Caribbean immigrants in the USVI.

Testing the theory of reasoned action in explaining sexual behavior among African American young teen girls.

This study tested the Theory of Reasoned Action to examine the prediction of early sexual behavior among African American young teen girls. Baseline data from a longitudinal randomized clinical trial were used. Between 2001 and 2005, 198 middle-school girls aged 11 to 14 years were recruited. As girls aged, they held more permissive attitudes toward engaging in early sexual behavior and had a higher intention to engage in early sexual behavior. Intention was a significant predictor to explain sexual behavior among the girls. There is a need to develop strategies that promote intention related to delay and prevention of early sexual behavior.

Another look at heterosocial behaviors: one side of the early intimate sexual behaviors coin.

The number of adolescent births is once again on the rise. Heterosocial competence described as successful interactions (i.e., heterosocial behaviors) with males (Grover, Nangler, & Zeff, 2005; Grover, Nangler, Serwik, & Zeff, 2007) is one emerging factor that has been found to be associated with adolescent sexual behavior. The aims of this cross sectional design study with 159 African American middle-school girls using the theory of reasoned action (Ajzen & Fishbein, 1980) were to describe and assess the relationship between heterosocial behaviors and sexual behaviors. Data was obtained using four surveys. The results suggest that heterosocial behaviors were a significant predictor of sexual behaviors (p < .001).

Influence of the parent-adolescent relationship on condom use among South Korean male college students.

This study examined the mediating role of condom self-efficacy between the parent-adolescent relationship and the intention to use condoms with a submodel based on the Theory of Planned Behavior. Male students aged 18-25 years (n = 176) were recruited from a university in Seoul, South Korea, using a flyer and self-referral in 2004. A sample of 170 male students was retained for the final data analyses as six subjects had incomplete data on more than one instrument. Condom self-efficacy completely mediated the prediction of intention to use condoms by the quality of the mother-son relationship. However, condom self-efficacy did not mediate the relationship between the quality of the father-son relationship and the intention to use condoms. Only an indirect effect between the quality of the father-son relationship and the intention to use condoms existed. The suggested sex education programs should develop culture-specific, theory-based, and family-based interventions in order to reduce risky sexual behavior among South Korean adolescents.

Evaluating the Theory of Planned Behavior to explain intention to engage in premarital sex amongst Korean college students: a questionnaire survey.

BACKGROUND: To reduce risky adolescent sexual behavior, education programs must be tailored to specific cultures and stage of adolescence. OBJECTIVES: This study describes the self-reported sexual behavior of Korean college students and examines the efficiency of the Theory of Planned Behavior (TpB) in explaining intention of engaging in premarital sex in order to provide insights for a potential sex education program designed to reduce risky sexual behavior. DESIGN: A cross-sectional, correlational design using an exploratory survey method was used. PARTICIPANTS: Participants were recruited from a university in Korea with a flyer posted at the entrance of the student health service center, and self-referral in 2004. Male and female unmarried college students aged 18 to 25 were included. Foreign students and students with visible physical problems were excluded. Three hundred and twenty of 550 students returned the questionnaire packets. Final data analysis included 298 students after deleting incomplete data. METHODS: Participants completed six questionnaires: (1) Background and Sexual Behavior Questionnaire, including items related to perceived risk of sexual behavior, (2) Parent-Adolescent Communication Scale, and four scales related to TpB construct: (3) modified Premarital Sexual Attitude Scale, (4) Referent group Approval of Sex Behavior Scale, (5) Sexual Abstinence Efficacy Scale and (6) modified version of Doswell's Intention of Sexual Behavior Scale. RESULTS: Premarital sexual attitude, abstinence self-efficacy and referent group norms were significant predictors of intention of premarital sex for male students with a large effect, but only attitude and norms predicted intention of premarital sex for female students. CONCLUSION: The TpB may be an effective theory to guide the development of theory-driven sexual abstinence interventions to reduce risky sexual behavior for Korean males, while the Theory of Reasoned Action may be an effective theory for Korean females.

The NIA Group. Building a sense of purpose in preadolescent African American girls: a novel approach to nursing leadership in community health.

Many African American girls experience pubertal development early. Earlier pubertal development may place these girls at greater risk of exposure to or engagement in early sexual behavior. Young girls facing this societal context need interventions to help them develop healthy self-esteem, pride in their cultural heritage, good decision-making skills and a sense of purpose. It was from these concerns that the NIA Program of Self-Development for preadolescent girls was initiated as a collaboration of the University of Pittsburgh School of Nursing, a local public school, and the nursing staff of the Matilda Theiss Health Center, a comprehensive community health center that houses the NIA Group. The group's name, "NIA," meaning a sense of purpose, is derived from one of the seven principles of Kwanzaa, a yearly African American celebration of cultural heritage.

Risk-taking behaviors in early adolescent minority women: implications for research and practice.

Adolescence is a time of biologic, intellectual, and psychosocial transition for young women. For an African American or Hispanic girl, the challenge of being female is compounded by the challenge of being a member of a minority group. In this article, the authors present the reproductive health challenges faced by African American and Hispanic girls and suggest research-based programs and nursing practice interventions to address these challenges.

Overview of female middle childhood in societal context: implications for research and practice.

Preadolescence represents a time of becoming and of change less emphasized in popular and empirical literature than adolescence. Yet it is an important period and a critical time to teach children, while they are still sufficiently adult-dependent and adult-centered, to help that learning to persist. These are formative years during which children experience marked increases in development (physical, cognitive, and psychosocial) and knowledge and an incremental shaping of values, attitudes, and behaviors that they will carry into adulthood. This period of life can also be called the "tween" years, as children during this period are transitioning to adolescence. The purpose of this article is to present an overview of the societal context in which preteen girls are developing and provide some suggestions for testing and implementing health promotion strategies that may contribute toward a safe and successful transition for these children through adolescence to adulthood in this fast-paced society.