Public willingness, attitudes and related factors toward cardiopulmonary resuscitation: A grounded theory study.

OBJECTIVES: Despite receiving cardiopulmonary resuscitation (CPR) training, over 50% of bystanders were unable to actually perform CPR. Understanding public willingness and attitudes toward bystander CPR is crucial in explaining whether people initiate CPR. This study aimed to develop a theoretical understanding of factors that influence the public's willingness and attitudes to perform CPR. DESIGN: This was a qualitative study using the grounded theory method. METHODS: The data were collected from semi-structured interviews with 28 participants between August 2022 and November 2022. Purposive sampling and theoretical sampling were used to recruit participants. Interviews were recorded and transcribed. Data were analyzed using open, axial, and selective coding. RESULTS: Nine categories and 24 subcategories were summarized from four aspects: willingness, attitudes, implementation, and training. Willingness included self-willingness, self-perception, and societal factors; attitudes covered personality traits, reactions to patients and environment; implementation comprised knowledge and skills, situational coping, and risk perception; training included CPR training accessibility and barriers to CPR training. A theoretical framework of public CPR willingness, attitudes, and their influencing factors was developed. CONCLUSION: The public's CPR willingness, attitudes, training, and implementation were interrelated and influential. The findings may have significant implications for the development of legislation and policy related to CPR popularization and training.

Systematic Review of the Influence of Physical Work Environment on Office Workers' Physical Activity Behavior.

BACKGROUND: Many American workers spend over 7 hours a day at work in primarily sedentary office work. Physical activity is a key aspect of optimizing health and preventing disease; yet, 80% of American adults do not meet the recommended guidelines for physical activity. In this systematic review, the relationship between physical work environment and physical activity among office workers was explored. METHODS: Of the 321 studies screened, 26 studies met the eligibility criteria and were included for evaluation in this systematic review. RESULTS: Of the 26 studies, four were cross-sectional studies, 14 were quasi-experimental studies, and eight were randomized control trials. Physical activity during the workday was measured using self-report surveys and electromechanical devices such as accelerometers. Physical work environments examined by the studies included different types of desks (n = 16), office arrangements (n = 5), and building design (n = 5). In nine studies, office environments and building work environments designed to promote activity using active design principles such as stairs and flexible workspaces were associated with increased physical activity. Sit-stand desks reduced overall sitting time, but had a minimal effect on physical activity. CONCLUSION/APPLICATION TO PRACTICE: Offices and buildings designed for activity had the largest impact on physical activity among office workers. To increase physical activity in office workers, focus should be placed on opportunities to increase incidental movement that can increase physical activity throughout the workday. Occupational health nurses should advocate workspace designs that can increase physical activity in workers.

Earning the Trust of African American Communities to Increase Representation in Dementia Research.

Black/African American populations are underrepresented as participants in dementia research. A major barrier to participation of African American older adults in dementia research is a tendency to distrust research institutions owing to both historical and contemporary racism. Building on the Ford framework, the objective of our study was to examine factors that influence participation in dementia research among African American older adults and caregivers, with an emphasis on understanding factors related to trust. Data were collected during January 2019 and March 2020 from 10 focus groups with African American older adults (n=91), 5 focus groups with caregivers (n=44), and interviews with administrators of community-based organizations (n=11), and meetings with our Community Advisory Board. Inductive/deductive content analysis was used to identify themes. The results identified an overall tension between distrust of researchers and a compelling desire to engage in dementia research. This overarching theme was supported by six themes that provided insights about the multiple layers of distrust, as well as expectations about the appropriate conduct of researchers and academic institutions. Strong commitment to the community was identified as a priority. The findings suggest that a paradigm shift is needed to increase the representation of African Americans in dementia research. In this new paradigm, earning the trust of African American communities becomes a systemic endeavor, with academic, state, and national institutions deeply committed to earning the trust of African American communities and guiding researchers in this endeavor. The findings also generated actionable recommendations to help improve representation of African American older adults in dementia research.

Two Different Buprenorphine Treatment Settings With Similar Retention Rates: Implications for Expanding Access to Treatment for Opioid Use Disorder.

INTRODUCTION: There is considerable need for effective and accessible treatment for opioid use disorder. AIMS: Our study explored differences in buprenorphine treatment retention and duration, with a focus on selected sociodemographic factors and treatment indicators, in two different settings: an office-based buprenorphine induction and stabilization clinic (OBIC) and a community-based primary care clinic (CPC). METHOD: This nonexperimental retrospective chart review compared demographic information and buprenorphine treatment details, including treatment retention and duration. RESULTS: There were no statistically significant differences in buprenorphine treatment indicators between the OBIC and CPC groups, with two exceptions: the number of written buprenorphine prescriptions was significantly greater for the OBIC group, as was the number of filled buprenorphine prescriptions. CONCLUSIONS: Given similar treatment retention and duration in two different buprenorphine treatment settings, our findings suggest that access to buprenorphine treatment in standard integrated care settings can be supplemented by novel treatment structures such as the OBIC in order to increase access to care during the current opioid epidemic.

Experiences and Perceptions of Black Men Who Have Sex with Men About Acquiring HIV: A Qualitative Narrative Perspective.

In the United States, Black men who have sex with men (MSM), between the ages of 18 and 34 years, have the highest rates of new HIV infections. The prevalence of HIV in this population is three to four times higher than their White MSM counterparts. Twelve Black MSM from the Bay Area, nine with HIV and three without HIV, were interviewed regarding their experiences and perceived risks of acquiring HIV. Narrative analysis revealed these themes: (a) tested regularly for HIV, (b) HIV knowledge varied before arriving in San Francisco, (c) condom use typically nonexistent when under the influence of alcohol and other drugs, (d) inability to negotiate sex and condom usage, and (e) sense of anticipation, resignation, and acceptance about acquiring HIV. Implications of this study highlight the need for Black MSM to have earlier HIV prevention education, including condom negotiation skills, particularly when under the influence of drugs and/or alcohol.

Nativity, Chronic Health Conditions, and Health Behaviors in Filipino Americans.

INTRODUCTION: Nearly half of Americans have a chronic health condition related to unhealthful behavior. One in four Americans is an immigrant; yet immigrants' health has been studied little, particularly among Asian American subpopulations. METHODOLOGY: Years lived in United States, hypertension, diabetes, smoking, walking, adiposity, and fruit/vegetable variables in the 2011-2012 California Health Interview Survey were analyzed to examine the influence of nativity on chronic health conditions and health behaviors in 555 adult Filipinos, the second largest Asian American immigrant subpopulation. RESULTS: Recent and long-term immigrant Filipinos had higher odds of having hypertension and diabetes, but lower odds of smoking and overweight/obesity compared with second-generation Filipinos. DISCUSSION: Being born in the United States may be protective against chronic health conditions, but not for healthful behaviors among Filipinos. Chronic disease prevention and health promotion strategies should consider nativity/length of residence, which may be a more consequential health determinant than other immigration and acculturation characteristics.

Depression, Perceived Health, and Right-of-Return Hopefulness of Palestinian Refugees.

PURPOSE: Displacement is traumatic and often an unwanted social change that can lead to a loss of identity and socioeconomic, physical, and psychological livelihood. The purpose of the study was to describe the association of perceived health and right-of-return hopefulness to depressive symptom severity in Palestinian refugees, taking into consideration gender and poverty. DESIGN: The descriptive, correlational study was framed within a socioecological lens. Data collection occurred between October 2015 and November 2015 in Amman, Jordan, which hosts the most Palestinian refugees in the world. The participants in the sample (N = 177) had a mean age of 36.9 years. METHODS: Participants responded to the Patient Health Questionnaire for depressive symptom severity, the RAND-36 perceived health item, and a statement about hopefulness to return to Palestine. Descriptive, correlation, and logistic and linear regression analyses were computed. FINDINGS: Results showed that 43% of participants had moderate to severe depressive symptoms, 42% lived in poverty, and 20% had fair or poor health; yet, 60% were hopeful about returning to Palestine. Participants who had better perceived health and right-of-return hopefulness were less likely to have symptoms of major depression. Perceived health was the only factor-not gender, poverty, or right-of-return hopefulness-that explained the variance in depressive symptoms. CONCLUSIONS: Palestinian adult refugees in Jordan exhibited symptoms of major depression that were associated with poorer perceived health and less hopefulness about repatriation to Palestine. CLINICAL RELEVANCE: Nurses with community or mental health specialization can play a major role by systematically screening refugees for depression using worldwide, evidence-based tools and by advocating for policies that can improve the health and living conditions of refugees.

Cardiometabolic risks, lifestyle health behaviors and heart disease in Filipino Americans.

BACKGROUND: Cardiovascular disease is the leading cause of death among all racial and ethnic populations in the USA. Cardiovascular risks and cardioprotective factors have been disparately estimated among Asian American subpopulations. AIMS: The study's purpose was to describe the cardiometabolic risks and lifestyle health behaviors associated with cardiovascular disease, considering age and gender, in Filipinos, the second largest Asian American population. METHODS: Secondary analysis was conducted of behavioral (smoking, walking, body mass index and soda, fast food and fruit/vegetable consumption), cardiometabolic (hypertension and diabetes) and heart disease variables in the 2011-2012 California Health Interview Survey. The metropolitan sample of Filipino American adults included 57.3% women and had a mean age of 47.9 ± 18.3 years ( n = 555). RESULTS: Among the sample, 7.4% had heart disease, 38.9% had hypertension, 16.6% had diabetes, 12.4% smoked cigarettes, 83.2% were insufficiently active, 54.2% were overweight/obese, 21.8% routinely ate fast food, 13.2% routinely drank soda and 90.3% did not meet the fruit/vegetable consumption recommendation. Age (unadjusted odds ratio [OR] = 1.0, p < 0.0001), hypertension (unadjusted OR = 4.8, p < 0.0001) and diabetes (unadjusted OR = 3.3, p = 0.001) were associated with heart disease. Hypertension was the single greatest heart disease risk, controlling for diabetes, age and gender (adjusted OR = 3.1, p = 0.006). CONCLUSIONS: Primary and secondary prevention and treatment of hypertension should be paramount, along with promotion of glucose control, regular moderate-intensity physical activity, weight management and increased fruit and vegetable consumption in the Filipino American population. A multidisciplinary, chronic care model that is population-specific, emphasizes integrated, comprehensive care and provides linkages between primary healthcare and community resources is recommended for practice.

A Community Based Program for Family Caregivers for Post Stroke Survivors in Thailand.

PURPOSE: The purpose of this study was to evaluate the effectiveness of the post-stroke care program within the community setting in Thailand. METHODS: This quasi-experimental study was a nonequivalent control group pre-test and post-test design. A total of 62 pairs of post-stroke patients and their family caregivers were recruited to the study (31 pairs per group). The intervention consisted of a four-week program that included distributing pertinent information, providing skill practice during post-stroke care sessions and utilizing strategies to enhance motivation and behavioral skills of family caregivers based on the information-motivation-behavioral skills model. The family caregivers' post-stroke care skills were evaluated. The patients' activities of daily living (ADLs) and complications were evaluated at baseline and immediately and 2-month post-intervention. Statistical analysis included chi-square test, Fisher's exact test, independent t-test, and two-way repeated measures' analysis of variance. RESULTS: After participating in the program, family caregivers in the experimental group significantly improved their post-stroke care knowledge and skills as compared to those in the control group (F = 585.81, p < .001). ADLs among post-stroke patients in the experimental group significantly increased over time and were higher than those in the control group (F = 46.01, p < .001). Moreover, complications among patients in the experimental group were less than those in the control group. CONCLUSIONS: The post-stroke care program improved family caregivers' post-stroke care skills which resulted in improved functional status and decreased complications among post-stroke patients.

Health-related quality of life of Palestinian refugees inside and outside camps in Jordan.

BACKGROUND: Jordan hosts more Palestinian refugees than any country in the world. Conditions under which people in a community live influence their health-related quality of life (HRQOL). PURPOSE: The purpose of this descriptive comparative cross-sectional study was to compare HRQOL of Palestinian refugees in Jordan who live inside camps with those who live outside camps. METHODS: Participants, recruited from inside the Baqa'a camp (n = 86) and the surrounding Abu Nsair community (n = 91), completed the World Health Organization Quality of Life Brief questionnaire. FINDINGS: There were disparities in education and social relations and environment HRQOL related to income and residency, but not gender, among refugees. CONCLUSION: Refugees living inside camps, particularly if poorer, fared worse than refugees living outside camps. Enhanced programs and policies may be needed to improve HRQOL, education, and socioeconomics for camp refugees. Nursing's perspective on refugee health could make an important contribution to humanitarian efforts and health diplomacy.

Infant Feeding Decision-Making and the Influences of Social Support Persons Among First-Time African American Mothers.

Background While breast milk is considered the gold standard of infant feeding, a majority of African American mothers are not exclusively breastfeeding their newborn infants. Objective The overall goal of this critical ethnographic research study was to describe infant feeding perceptions and experiences of African American mothers and their support persons. Methods Twenty-two participants (14 pregnant women and eight support persons) were recruited from public health programs and community based organizations in northern California. Data were collected through field observations, demographic questionnaires, and multiple in-person interviews. Thematic analysis was used to identify key themes. Results Half of the mothers noted an intention to exclusively breastfeed during the antepartum period. However, few mothers exclusively breastfed during the postpartum period. Many participants expressed guilt and shame for not being able to accomplish their antepartum goals. Life experiences and stressors, lack of breastfeeding role models, limited experiences with breastfeeding and lactation, and changes to the family dynamic played a major role in the infant feeding decision making process and breastfeeding duration. Conclusions for Practice Our observations suggest that while exclusivity goals were not being met, a considerable proportion of African American women were breastfeeding. Future interventions geared towards this population should include social media interventions, messaging around combination feeding, and increased education for identified social support persons. Public health measures aimed at reducing the current infant feeding inequities would benefit by also incorporating more culturally inclusive messaging around breastfeeding and lactation.

Factors influencing health behaviors among active duty Air Force personnel.

BACKGROUND: Individual health behaviors affect whether U.S. Air Force (USAF) service members are fit and ready to deploy. PURPOSE: The purpose of this study was to understand health behaviors of USAF members to guide future interventions to reduce cardiovascular risks. METHODS: A qualitative descriptive study was conducted with a purposive sample of 24 active duty USAF participants. Conventional content analysis was used to derive data-driven themes that were compared with the Health Promotion Model (HPM). DISCUSSION: Participants defined health in a multifactorial way that covered physical, emotional, and spiritual dimensions. The three themes that contributed to participants' health behaviors addressed: "who I am," "what works for me," and the USAF culture. There was a poor fit between findings as expressed by these participants and the HPM. CONCLUSION: Although these findings were derived from a sample of USAF participants, the findings have implications for members of other military services. The findings also have relevance for nurses and other providers within the civilian work environments who can promote health and wellness by integrating a client's personal history into a plan for developing and sustaining a healthy lifestyle.

Breastfeeding and use of social media among first-time African American mothers.

OBJECTIVE: To describe the use of social media during the antepartum and postpartum periods among first-time African American mothers and their support persons. DESIGN: A qualitative critical ethnographic research design within the contexts of family life course development theory and Black feminist theory. SETTING: Participants were recruited from community-based, public health, and home visiting programs. PARTICIPANTS: A purposive sample was recruited, consisting of 14 pregnant African American women and eight support persons. METHODS: Pregnant and postpartum African American women and their support persons were interviewed separately during the antepartum and postpartum periods. Data were analyzed thematically. RESULTS: Participants frequently used social media for education and social support and searched the Internet for perinatal and parenting information. Most participants reported using at least one mobile application during their pregnancies and after giving birth. Social media were typically accessed through smartphones and/or computers using different websites and applications. Although participants gleaned considerable information about infant development from these applications, they had difficulty finding and recalling information about infant feeding. CONCLUSION: Social media are an important vehicle to disseminate infant feeding information; however, they are not currently being used to full potential. Our findings suggest that future interventions geared toward African American mothers and their support persons should include social media approaches. The way individuals gather, receive, and interpret information is dynamic. The increasing popularity and use of social media platforms offers the opportunity to create more innovative, targeted mobile health interventions for infant feeding and breastfeeding promotion.

How community trust was gained by an NGO in Malawi, Central Africa, to mitigate the impact of HIV/AIDS.

Trust is valuable social capital that is essential for effective partnerships to improve a community's health. Yet, how to establish trust in culturally diverse communities is elusive for many researchers, practitioners, and agencies. The purpose of this qualitative study was to obtain perspectives of individuals working for a nongovernmental organization (NGO) about gaining community trust in Malawi in order to mitigate the impact of HIV/AIDS. Twenty-six interviews were conducted over 12 months. Content analysis revealed the relationship between NGO staff and the community is crucial to gaining community trust. Gender, social context, and religious factors influence the establishment of trust within the relationship, but NGO assumptions about the community can erode community trust. Nurses and other health professionals working with the NGOs can help create conditions to build trust in an ethically and culturally sensitive manner whereby communities can develop processes to address their own health concerns.

Testing the efficacy of culturally adapted coping skills training for Chinese American immigrants with type 2 diabetes using community-based participatory research.

Chinese Americans demonstrate greater prevalence of diabetes than non-Hispanic whites and find standard diabetes care disregards their cultural health beliefs. Academic researchers and Chinatown agencies collaborated to culturally adapt and test an efficacious cognitive-behavioral intervention using community-based participatory research. Using a delayed-treatment repeated-measures design, 145 adult Chinese immigrants with Type 2 diabetes completed treatment. Immediate benefits of treatment were evident in the improvement (p < .05) in diabetes self-efficacy, diabetes knowledge, bicultural efficacy, family emotional and instrumental support, diabetes quality of life, and diabetes distress. Prolonged benefits were evident in all changed variables 2 months post-intervention. The CBPR approach enabled the development of a culturally acceptable, efficacious behavioral intervention, and provides a model for working with communities that demonstrate health disparities.