Promoting Health Literacy Among Adult ELLs Virtually During COVID-19.

The adult English language learner (ELL) population is often overlooked in health literacy discussions, which can result in perpetuating low health literacy and unfamiliarity with and low access to community resources. Health literacy interventions can reduce the impacts of social determinants of health. We examine the experience of a virtual health literacy educational course, Health in the English Language, for ELLs at Alaska Literacy Program (ALP), an Anchorage nonprofit. Our class was designed to help students navigate interactions with health care services, including medical care, pharmacy, health insurance, and nutrition resources. After 2 years of in-person teaching by university undergraduates, COVID-19 required a pivot to virtual instruction in Zoom in the summer of 2020. Instructors describe lessons learned and adjusting to student needs, community-building and personal connections, and the complexities of the topic of health literacy. ALP collaboration with university students continues to be a successful partnership to build health literacy capacity. Adoption of virtual instruction during COVID demonstrated the role that partnerships between nonprofits and university students can play to benefit all partners in the collaboration.

Factors Associated With Disordered Eating Behavior Among Adolescent Girls: Screening and Education.

INTRODUCTION/OBJECTIVES: An unhealthy relationship with food can lead to disordered eating in adolescence, highlighting the importance of screening. This study describes the frequency of disordered eating behavior among female adolescents, as well as associated characteristics and health behaviors. METHODS: Data are from a multidimensional risk factor screening survey administered at a university medical center's adolescent clinic from 2016 to 2018. The instrument was adapted from existing screening tools such as the Rapid Assessment for Adolescent Preventive Services (RAAPS), the American Medical Association's Guidelines for Adolescent Preventive Services (GAPS), and the Youth Risk Behavior Survey (YRBS). Analysis was limited to self-reported responses provided by females aged 10 to 21 years (N = 915). Statistical analyses included chi-square tests and independent sample T-tests. RESULTS: Of the N = 915 females who reported on disordered eating behavior, n = 57 (6.2%) had engaged in some form of disordered eating behavior within the past 12 months. Disordered eating was significantly associated (P < .001) with not consistently wearing a helmet while biking, having tried e-cigarettes, being bullied in the past 30 days, having an adverse childhood experience (ACE), and being African American (P = .005). Subgroup analysis of the relationship between disordered eating and bullying, by race, yielded significant findings: disordered eating was more highly associated with being bullied in the past 30 days among African American females (P = .038). The relationship between disordered eating and ACE was also significant (P < .001) among Caucasian girls when stratified by race. CONCLUSIONS: Adolescent risk behaviors often co-occur, and disordered eating behavior may be differentially observed by race. Findings highlight the importance of education and screening to prevent the development of disordered eating, and identify those who may be struggling. These results can be useful to community health education and in healthcare to develop and implement health promotion and eating disorder prevention strategies. Further studies are needed to assess additional factors that promote or protect against disordered eating to improve prevention.

Psychosocial impacts on college students providing mental health peer support.

Objective: To examine psychosocial effects on college student peer support workers of providing mental health peer support as compared to other trained student workers. Participants: From August 2016 through May 2017, undergraduate students trained to provide mental health peer support were compared to trained student workers not providing peer support. Methods: A post-training, post-working survey design was used to assess psychosocial effects using Keyes' Mental Health Continuum Short Form, the Deakin Coping Scale, and the Interpersonal Support Evaluation List. Results: At completion of training, peer supporters had lower flourishing (-9.5%, p = 0.090) than controls. After 6 weeks' work, peer supporters exhibited lowered avoidance coping (-62%, p = 0.023), and more belonging support (+9.5%, p = 0.044). Conclusions: Peer supporters' mental wellness does not decrease over the course of working as a mental health peer support worker; conversely, some aspects of well-being improve.

A developmental trajectory supporting the evaluation and achievement of competencies: Articulating the Mastery Rubric for the nurse practitioner (MR-NP) program curriculum.

BACKGROUND: Advanced practice registered nursing (APRN) competencies exist, but there is no structure supporting the operationalization of the competencies by APRN educators. The development of a Mastery Rubric (MR) for APRNs provides a developmental trajectory that supports educational institutions, educators, students, and APRNs. A MR describes the explicit knowledge, skills, and abilities as performed by the individual moving from novice (student) through graduation and into the APRN career. METHOD: A curriculum development tool, the Mastery Rubric (MR), was created to structure the curriculum and career of the nurse practitioner (NP), the MR-NP. Cognitive task analysis (CTA) yielded the first of the three required elements for any MR: a list of knowledge, skills, and abilities (KSAs) to be established through the curriculum. The European guild structure and Bloom's taxonomy of cognitive behaviors provided the second element of the MR, the specific developmental stages that are relevant for the curriculum. The Body of Work method of standard setting was used to create the third required element of the MR, performance level descriptors (PLDs) for each KSA at each of these stages. Although the CTA was informed by the competencies, it was still necessary to formally assess the alignment of competencies with the resulting KSAs; this was achieved via Degrees of Freedom Analysis (DoFA). Validity evidence was obtained from this Analysis and from the DoFA of the KSAs' alignment with principles of andragogy, and with learning outcomes assessment criteria. These analyses are the first time the national competencies for the NP have been evaluated in this manner. RESULTS: CTA of the 43 NP Competencies led to seven KSAs that support a developmental trajectory for instruction and documenting achievement towards independent performance on the competencies. The Competencies were objectively evaluable for the first time since their publication due to the psychometric validity attributes of the PLD-derived developmental trajectory. Three qualitatively distinct performance levels for the independent practitioner make the previously implicit developmental requirements of the competencies explicit for the first time. DISCUSSION: The MR-NP provides the first articulated and observable developmental trajectory for the NP competencies, during and beyond the formal curriculum. A focus on psychometric validity was brought to bear on how learners would demonstrate their development, and ultimately their achievement, of the competencies. The MR-NP goes beyond the competencies with trajectories and PLDs that can engage both learner and instructor in this developmental process throughout the career.

Reducing 30-day readmissions: health literacy strategies.

The imperatives of the Affordable Care Act to reduce 30-day readmissions present challenges and opportunities for nurse administrators. The literature suggests success in reducing readmissions through enhancing patient-centered discharge processes, focusing on medication reconciliation, improving coordination with community-based providers, and effective patient self-management of their disease and treatment. Evidence-based interventions addressing low health literacy, when used with all patients, hold promise to promote understanding and self-management. Strategies addressing low health literacy aimed at reducing 30-day readmissions are identified and discussed.

Perceived stress and social support in undergraduate nursing students' educational experiences.

BACKGROUND: Nursing students experience high levels of stress. Coping mechanisms such as utilization of social support are effective in managing the effects of stress and promoting individual well-being. The use of social support from faculty members and peers in nursing programs has not been studied sufficiently. Faculty members who can perceive and understand student emotions add to the students' positive perception of the educational environment, making it more conducive to learning. OBJECTIVES: To identify the stress experience and use of social support as a coping mechanism in traditional and second degree nursing students' educational experiences. DESIGN: A mixed method study was conducted. SETTING: Undergraduate nursing students at a private university. PARTICIPANTS: 107 baccalaureate nursing students enrolled in either a traditional (n=49) or second degree (n=58) program during the Fall 2011 semester. METHOD: Five instruments were combined to develop the quantitative and qualitative questions for an online survey. RESULTS: Traditional and second degree nursing students report high levels of anxiety, worry and depression in response to stress, resulting in feelings of rejection and inadequacy. Respondents used faculty members for support less frequently than they used their peers, spouse/significant other or parents. Second degree students and traditional students differ in their level of alcohol consumption with traditional students more likely to drink heavily than second degree students. In addition, traditional students are more likely to use fellow nursing students and other friends as social support, whereas second degree students rely more on their spouse/significant other. CONCLUSION: Students' high levels of maladaptive reactions to stress should encourage educators to help students develop positive coping strategies. Educators have the potential to impact the development of their students as they transition into nurses capable of handling the rigors of the profession.

The effect of a pedagogy of curriculum infusion on nursing student well-being and intent to improve the quality of nursing care.

AIM: The aim of this study was to determine if a pedagogy of curriculum infusion promotes nursing student well-being and intent to address quality care indicators of Quality and Safety Education for Nurses (QSEN) and American Association of Colleges of Nursing. METHODS: This mixed-method experimental design study is based on 86 students' experiences with curriculum infusion as an intervention in two undergraduate nursing courses from August to December 2011. Student reflections, case analyses, and narrative evaluations were examined. FINDINGS: Students experiencing curriculum infusion demonstrated intention to provide quality care as evidenced by case analysis and personal reflections. CONCLUSION: Students acknowledged the importance of self-care and demonstrated intention to provide quality nursing care in five of the six QSEN competencies. Educators must be mindful to educate the whole student.

Care of the patient with Prader-Willi syndrome.

Prader-Willi syndrome (PWS), a complex, neurodevelopmental genetic disorder with an estimated incidence of 7 in 10,000-29,000 people, is found in all races and both genders. It is the most commonly identified genetic cause of obesity. A multidisciplinary approach to managing PWS is highlighted, along with elements that should be included in a treatment plan, to help nurses deliver comprehensive care to meet the complex biopsychosocial needs of adults with PWS.

Curriculum infusion to promote nursing student well-being.

AIM: This paper is a report of a study of baccalaureate nursing students' experiences with curriculum infusion of college health issues into academic courses and students' well-being. BACKGROUND: Bringing Theory to Practice is an ongoing project at a number of colleges in the United States of America. Its goal is to use the academic classroom and campus community to engage students actively in self-reflection on a variety of common college student health and well-being issues. METHOD: This qualitative study was based on 159 students' experiences with curriculum infusion in two undergraduate nursing courses at a university in the United States of America over a 2-year period from 2006 to 2008. Student reflection papers, photo-essays, narrative course evaluations, classroom engagement with educators and peers and student use of campus health resources were the data examined. FINDINGS: As a result of the integration of personal wellness concepts into classroom pedagogy, students experienced a variety of feelings and needs including isolation, shock and anger, taking time, awareness and valuing. CONCLUSION: In light of the increasing rigour of baccalaureate nursing programmes, it is important for educators to be aware of the health-related effects of stress and isolation on students. By increasing student self-awareness and changing relational dynamics in the classroom, student well-being can be supported.

Low health literacy: a challenge to critical care.

Health literacy-"the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions"-has been identified as a cross-cutting quality-of-care issue by the Institute of Medicine. This article defines the scope of the health literacy problem, discusses the literacy demands of critical care, and offers strategies for nurses to improve the quality of health communication with patients and families in the critical care environment.