Testing Race Differences in Risk of Gestational Diabetes Mellitus Associated with Household Food Insecurity (Using NHANES 2007-2018).

OBJECTIVE: This study aimed to estimate the association of household food insecurity with gestational diabetes mellitus (GDM) risk by race and ethnic group. STUDY DESIGN: The study was a secondary analysis from the National Health and Nutrition Examination Survey from 2007 to 2018. A survey-weighted logistic regression model was constructed with self-reported GDM as the response. The primary independent variable was a four-level food security indicator, defined as the inability to obtain food in a socially acceptable way due to the lack of financial resources and controlled for several established risk factors. Analyses were stratified by race (White and Black) and ethnicity (Hispanic) to provide insight into how gestational diabetes risk differs by subpopulation. RESULTS: Results indicated that family history of diabetes is a risk factor across all races (adjusted odds ratio [aOR]: 4.22-16.26), while household food insecurity is a significant risk factor for only Hispanic women living with a partner (aOR: 8.50 for very low food security). CONCLUSION: In the United States, Hispanic women's GDM risk may be uniquely impacted by food insecurity. KEY POINTS: · This study provides a national estimate of the GDM risk from food insecurity by race and ethnicity.. · The results in this study suggest a statistically significant relationship between household food insecurity and an increasing risk of developing GDM for Hispanic individuals.. · White women who live alone (without spouse or partner) were also at elevated risk of GDM.. · Age at delivery, poverty ratio, and family history of diabetes are also risk factors for the disease..

Application of the PERMA Model of Well-being in Undergraduate Students.

The PERMA model was introduced by Seligman in 2011 to increase and measure well-being. This model defines well-being in terms of Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA). Mental health concerns are common in undergraduate students and may prevent them from obtaining optimal well-being. The purpose of this study was to test whether all five PERMA elements of well-being could be constructed from items within the 2018 Purdue University Student Experience at a Research University (SERU) survey. Using confirmatory factor analysis, all five PERMA constructs were supported and demonstrated good model fit statistics. A second order PERMA well-being construct was built and demonstrated adequate model fit with RMSEA = 0.04. All five constructs were significant at p < .001. Accomplishment had the highest factor loading (0.76) and Meaning had the lowest factor loading (0.25). Results for this study support use of well-being theory in the context of undergraduate students and provides enhanced understanding of well-being characteristics in this population.

Subjective Well-Being, Depression, and Delays in Care Among Older Adults: Dual-Eligible Versus Medicare-Only Beneficiaries.

We aimed to (a) determine the role of subjective well-being and depression in care delays among Medicare beneficiaries and (b) examine whether subjective well-being and depression play a differential role among Medicare-only and dual-eligible beneficiaries. A nationally representative sample of 1,696 older adults participated in the study. Roughly, 22% of participants reported often or sometimes experiencing care delays, with more delays among dual eligibles. We found that higher levels of subjective well-being were significantly related to less frequent care delays. In contrast, higher levels of depression were significantly related to more frequent care delays. Moreover, as depression increased, the predicted probability of delays increased to a greater extent among dual eligibles than Medicare-only beneficiaries. These findings signify the importance of identifying and implementing strategies to enhance subjective well-being and reduce depression in older adults, particularly dual eligibles, to improve access to timely care.

Outcomes of primary care-based Medicare annual wellness visits with older adults: A scoping review.

The increasing aging population creates many challenges for countries around the world. Keeping this population healthy to prevent frailty and functional decline requires a stronger focus on health promotion and disease prevention. Maximization of well-being and quality of life of older adults can occur if determinants of health are addressed and preventive behaviors are supported. Primary care-based preventive visits such as the Medicare annual wellness visit can be used with older adults to enhance health promotion efforts. A scoping review of studies was conducted to identify current evidence concerning the impact of this visit on preventive practices, risk reduction and lifestyle behavior changes for community-dwelling older adults. A total of 11 studies were included in this review. Preventive services use outcomes including vaccinations and screenings were most frequently reported. Visits such as these can provide a platform for development of strategies to provide ongoing support for health promotion efforts.

Improving teaching assistants' orientation in a school of nursing: a lean approach.

Newly hired teaching assistants (TAs) come to schools of nursing with varying levels of experience in academic institutions. Therefore, the orientation of TAs becomes important at a micro level (student instruction) and macro level (mission of the organization). We describe a Lean approach to strengthening TA orientation and reducing waste and inconsistency. Developed solutions and tools through the lens of quality improvement are discussed.

Lifestyle behavior change and repeat health risk appraisal participation: a structural equation modeling approach.

PURPOSE: Health risk appraisals (HRAs) have been used to address multiple health concerns and lifestyle behaviors. We explore the longitudinal relationship between emotional health, stage of change for five lifestyle behaviors, and lifestyle risks using HRA-generated data. DESIGN: Secondary analysis of 3 years of HRA data. SETTING: A large health care management services provider. SUBJECTS: A total of 7535 adults employed across three companies who completed consecutive HRAs over a 3-year period. MEASURES: Self-report items concerning participant health, lifestyle behaviors, disease risk factors, job/life satisfaction, safety, and biometrics. ANALYSIS: Structural equation modeling tested a hypothesized longitudinal, fully cross-lagged panel design. RESULTS: Results indicated that greater numbers of physical and behavioral risks classified as high risk were associated with greater intention to change or an actual change in lifestyle behavior in the following year. In addition, poorer emotional health was associated with a higher number of risks. CONCLUSION: Data from repeat participation in HRAs can be useful in studying multiple risk behaviors and related health measures, supporting the design and evaluation of effective, individualized, and responsive health promotion activities for working adults.

Making it meaningful: Teaching public health nursing through academic-community partnerships in a baccalaureate curriculum.

Because of the importance, and difficulty, of providing public health clinical experiences for baccalaureate nursing students, a small midwestern school of nursing offered students a three-year assignment to agencies serving vulnerable populations. The program allowed for long-term placement of students, instilling in them an understanding of community health as a prime aspect of nursing care. Students mentored students, which enhanced continuity in the agencies. More than 2,000 community members have been served, and students' responses have been overwhelmingly positive.