Prevalence of Low or Very Low Food Security in Undergraduate Nursing Students.

ABSTRACT: Food insecurity occurs when there is a lack of resources to obtain food. This study sought to identify the prevalence of food insecurity in baccalaureate nursing students. Data on demographics, perceived stress, food security, and food access were collected using a survey from 201 baccalaureate nursing students. Nearly 43 percent of students reported food insecurity within the last year. Students reporting food insecurity reported higher levels of perceived stress (p < .01). Findings support that food insecurity is prevalent in nursing students. An increase in awareness, assessment, and efforts to provide early interventions should be considered.

Applying Kern's Model to the Development and Evaluation of Medical Student Well-Being Programs.

The Liaison Committee on Medical Education (LCME) requires that well-being programs must be "effective." Yet most medical schools do not robustly assess their well-being programs. Most evaluate their programs using one question on the Association of American Medical College's annual Graduation Questionnaire (AAMC GQ) survey for fourth-year students on their satisfaction with well-being programs, which is inadequate and nonspecific and only assesses a specific time in training. In this perspective, we, as members of the AAMC Group on Student Affairs (GSA) - Committee on Student Affairs (COSA) Working Group on Medical Student Well-being, suggest adapting Kern's 6-step approach to curriculum development as an effective framework to guide the development and evaluation of well-being programs. We suggest strategies for applying Kern's steps to well-being programs, with attention to conducting needs assessments, identifying goals, implementation, and evaluation and feedback. While each institution will have unique goals emerging from their needs assessment, we put forth five common medical student well-being goals as examples. Applying a rigorous and structured approach to developing and evaluating undergraduate medical education well-being programs will involve defining a guiding philosophy and clear goals and implementing a strong assessment strategy. This Kern-based framework can help schools meaningfully assess the impact of their initiatives on student well-being.

Understanding the perceptions of sedentary college students' engagement in physical activity: application of the theory of planned behavior.

OBJECTIVE: To understand salient beliefs related to physical activity (PA) in sedentary college students. PARTICIPANTS: Thirty-seven students from a large research university participating in a larger research project were subsequently invited to participate in small focus groups. METHODS: Using the Theory of Planned Behavior as a framework, semi-structured focus groups were conducted to understand the perceptions of using mobile technology as a tool to increase PA. RESULTS: A grounded theory approach revealed that students generally had positive attitudes about PA and relied heavily on social support as a facilitator of PA behavior change. The structured exercise program delivered via the mobile app increased perceived behavioral control. Other key findings include academic barriers, desire to avoid chronic disease, and inconsistent efficacy of the mobile application among this population. CONCLUSIONS: Interventions designed to increase PA in this population should focus on structured activity, increased self-monitoring, positive outcome expectancies, and social support.

Assessing college students' interest in university-based oral health information and services.

Objective: To assess US college students' (1) oral health behaviors and (2) interest in university-based oral health information and services. Participants: Students at a large public university in the southeast participated in the survey (n = 102). All participants were over the age of 18 and able to speak and read English. Methods:An online quantitative survey was administered to collect information on oral health behaviors, interest in university-based oral health information and services, and sociodemographic factors. Frequencies, descriptive statistics, and bivariate analyses were utilized for this study. Results: Approximately 11% of students rated their oral health as fair/poor and 27% currently had a dental problem. Over half (53%) were interested in receiving oral health information from the university, 87% felt campus-based dental services were important, and 79% were likely to use campus-based dental services. Conclusions: College students may benefit from information and services to promote oral health within the college context.

Characterizing User Experiences With an SMS Text Messaging-Based mHealth Intervention: Mixed Methods Study.

BACKGROUND: Limited access to mental health care services due to provider shortages, geographic limitations, and cost has driven the area of mobile health (mHealth) care to address these access gaps. Reports from the Cohen Veterans Network and National Council for Behavioral Health show that in states where mental health care is more accessible, 38% of people still do not receive the care they need. mHealth strategies help to provide care to individuals experiencing these barriers at lower cost and greater convenience, making mHealth a great resource to bridge the gaps. OBJECTIVE: We present a mixed methods study to evaluate user experiences with the mental mHealth service, Cope Notes. Specifically, we aimed to investigate the following research questions: How do users perceive the service in relation to stigma, impact of the intervention, and perceived usefulness? How do users rate the Cope Notes service and SMS text messaging along various dimensions of acceptability? What is the relationship between Cope Notes SMS text message ratings, user personality, and coping strategies? What are user perspectives of leveraging ubiquitous sensing technologies to improve delivery and provide tailored content? METHODS: We performed qualitative interviews with Cope Notes users (N=14) who have used the service for at least 30 days to evaluate their experiences and usefulness of the service. These interviews were coded by 2 raters (SLK and JL), and the interrater reliability was calculated with SPSS (IBM Corp) at 61.8%. In addition, participants completed quantitative measures, including a user experiences survey, personality inventory (Big Five Inventory-10), and coping assessment (Brief Coping Orientation to Problems Experienced). RESULTS: We derived 7 themes from our qualitative interviews: Likes or Perceived Benefits, Dislikes or Limitations, Suggested Changes, Stigma or Help Seeking, Perceptions of Ubiquitous Sensing, Cultural Sensitivity, and Alternative mHealth Resources. Exploratory analyses between acceptability ratings of Cope Notes and personality factors showed statistically significant positive relationships between seeing oneself as someone who is generally trusting and acceptability items, the most significant being item 7 (I fully understood the sentiment behind Cope Notes Messages) with (rs(10)=0.82, P=.001). We also found statistically significant relationships between acceptability and Brief Coping Orientation to Problems Experienced items, with the strongest positive correlation between participants strongly endorsing coping by accepting the reality that an event has happened and acceptability item 7 (rs(8)=0.86, P=.001). CONCLUSIONS: Our study found that Cope Notes subscribers appreciate the service for reframing their mental wellness with statistically significant correlations between personality and acceptability of the service. We found that some users prefer a more personalized experience with neutral to positive reactions to a potential companion app that continuously monitors user behavior via smartphone sensors to provide just-in-time interventions when users need it most.

Maladaptive Perfectionism, Impostor Phenomenon, and Suicidal Ideation Among Medical Students.

OBJECTIVE: Suicide is a leading cause of death for young adults, and medical students experience elevated rates of suicide and suicidal ideation. The present study uses mediation analysis to explore relationships between suicidal ideation and two dysfunctional mindsets common among medical students: maladaptive perfectionism, high standards accompanied by excessive self-criticism, and impostor phenomenon, pervasive feelings of inadequacy despite evidence of competence and success. METHODS: Two hundred and twenty-six medical students at a single institution completed an online survey which assessed maladaptive perfectionism, impostor phenomenon, and suicidal ideation. After calculating measures of association between all study variables, linear regression was conducted to establish the relationship between maladaptive perfectionism and suicidal ideation. To evaluate whether impostor phenomenon mediated the relationship between maladaptive perfectionism and suicidal ideation as hypothesized, a series of regression models were constructed and the regression coefficients were examined. The statistical significance of the indirect effect, representing the mediated relationship, was tested using bootstrapping. RESULTS: Significant positive associations between maladaptive perfectionism, impostor phenomenon, and suicidal ideation were observed. Impostor phenomenon score was found to mediate the relationship between maladaptive perfectionism and suicidal ideation. CONCLUSIONS: Medical students who exhibit maladaptive perfectionism are at increased risk for feelings of impostor phenomenon, which translates into increased risk for suicide. These results suggest that an intervention targeted at reducing feelings of impostor phenomenon among maladaptive perfectionists may be effective in reducing their higher risk for suicide. However, interventions promoting individual resilience are not sufficient; systemic change is needed to address medicine's "culture of perfection."

Fruit and vegetable consumption and psychological distress in Australian pregnant and breastfeeding women.

BACKGROUND AND OBJECTIVES: Mental health disorders amongst pregnant and postpartum women are an increasing public health concern. Our aim was to determine the association between fruit and vegetable intake and psychological distress in a nationally representative sample of Australian pregnant and breastfeeding women. METHODS AND STUDY DESIGN: This study used cross-sectional data collected by the Australian Bureau of Statistics in the 2014 to 2015 Australian National Health Survey. Participants included 166 pregnant and 207 breastfeeding women >18 years old. Number of serves of fruit and vegetables usually consumed each day was reported. The Kessler Psychological Distress Scale (K10) measured levels of global non-specific psychological distress. The association between fruit and vegetable intake and psychological distress was investigated using linear regression adjusted for available known covariates (age, education, physical activity). RESULTS: Mean±SD fruit intake was greater in pregnant compared to breastfeeding women (2.0±1.0 versus 1.7±1.0, p<0.05). The mean K10 score for both the pregnant and breastfeeding women was in the 10-15 'little or no psychological distress" range. In pregnant women, combined fruit and vegetable intake was inversely associated with psychological distress in the fully adjusted model (ß=-0.37, 95% CI -0.72, -0.02). There was no association between fruit and vegetable intake and psychological distress in breastfeeding women. CONCLUSIONS: A higher intake of combined fruit and vegetables was found to be associated with less psychological distress in pregnant women. Further research, including longitudinal and intervention studies, are required to determine causality between fruit and vegetable intake and psychological distress in this population group.