Addressing health disparities of individuals experiencing homelessness in the U.S. with community institutional partnerships: An integrative review.

AIMS: To examine existing community-institutional partnerships providing health care services to people experiencing homelessness by addressing social determinants of health (SDOH) at multiple socioecological levels. DESIGN: Integrative review. DATA SOURCES: PubMed (Public/Publisher MEDLINE), CINAHL (The Cumulative Index of Nursing and Allied Health Literature database), and EMBASE (Excerpta Medica database) were searched to identify articles on health care services, partnerships, and transitional housing. REVIEW METHODS: Database search used the following keywords: Public-private sector partnerships, community-institutional relation, community-academic, academic community, community university, university community, housing, emergency shelter, homeless persons, shelter, and transitional housing. Articles published until November 2021 were eligible for inclusion. The Johns Hopkins Nursing Evidence-Based Practice Quality Guide was used to appraise the quality of articles included in the review by two researchers. RESULTS: Seventeen total articles were included in the review. The types of partnerships discussed in the articles included academic-community partnerships (n = 12) and hospital-community partnerships (n = 5). Health services were also provided by different kinds of health care providers, including nursing and medical students, nurses, physicians, social workers, psychiatrists, nutritionists, and pharmacists. Health care services spanning from preventative care services to acute and specialized care services and health education were also made possible through community-institutional partnerships. CONCLUSION: There is a need for more studies on partnerships that aim to improve the health of homeless populations by addressing social determinants of health at multiple socioecological levels of individuals who experience homelessness. Existing studies do not utilize elaborate evaluation methods to determine partnership efficacy. IMPACT: Findings from this review highlight gaps in the current understanding of partnerships that seek to increase access to care services for people who experience homelessness. NO PATIENT OR PUBLIC CONTRIBUTION: The results of the systematic review were solely from the articles reviewed and do not include information from patients, service users, caregivers, or members of the public.

Addressing systemic racism and intergenerational transmission of anxiety using Bowenian family therapy with African American populations: A Discursive paper.

AIM: To examine the intergenerational impact of systemic racism on mental health, depicting the evolution and patterns of anxiety symptoms and the application of the Bowenian family therapy to understand the interrelatedness and long-standing impact of intergenerational trauma in African American families. This article highlights interventions that increase awareness of and promotes physical and mental health for African American populations. DESIGN: Discursive Paper. METHOD: Searching literature published between 2012 and 2022 in PubMed, SCOPUS, EBSCO Host and Google Scholar, we explored factors associated with systemic racism and generational anxiety. DISCUSSION: Evidence-based literature supports the application of the Bowenian family therapy theoretical framework to understand the intergenerational impact of systemic racism and to address the transmission of anxiety symptoms in African American  populations. CONCLUSION: Culturally appropriate interventions are needed to decrease anxiety symptoms in an attempt to heal intergenerational trauma and to improve family dynamics in African American populations. IMPACT TO NURSING PRACTICE: Nurses play an integral role in providing holistic quality patient-centred care for African American populations who have experienced racial trauma. It is critical for nurses to implement culturally responsive and racially informed care with patients that focuses on self-awareness, health promotion, prevention and healing in efforts to address racial trauma. Application of Bowenian family therapy can aid in the reduction of both intergenerational transmission of racial trauma and generational anxiety. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or drafting of this discursive paper. The authors reviewed the literature to develop a discussion.

Factors influencing intrapartum health outcomes among Black birthing persons: A discursive paper.

AIM: To examine factors that influence intrapartum health outcomes among Black childbearing persons, including cisgender women, transmasculine and gender-diverse birthing persons. BACKGROUND: Black childbearing persons are three to four times (243%) more likely to die while giving birth than any other racial/ethnic group. Black birthing persons are not just dying from complications but also from inequitable care from healthcare providers compared to their white counterparts. DESIGN: Discursive paper. METHOD: Searching national literature published between 2010 and 2021 in PubMed, CINAHL, Embase and SCOPUS, we explored factors associated with poor intrapartum health outcomes among Black childbearing persons. DISCUSSION: Several studies have ruled out social determinants of health as sufficient causative factors for poor intrapartum health outcomes among Black birthing persons. Recent research has shown that discrimination by race heavily influences whether a birthing person dies while childbearing. CONCLUSIONS: There is a historical context for obstetric medicine that includes harmful stereotypes, implicit bias and racism, all having a negative impact on intrapartum health outcomes. The existing health disparity among this population is endemic and requires close attention. IMPACT ON NURSING PRACTICE: Nurses and other healthcare professionals must understand their role in establishing unbiased care that promotes respect for diversity, equity and inclusion. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or drafting of this discursive paper.

Promoting community institutional partnerships to improve the health of intimate partner violence survivors experiencing homelessness.

BACKGROUND: Disparities faced by individuals experiencing homelessness pose significant threats to the health and wellbeing of communities. Survivors of intimate partner violence are at heightened risk, with over 80% experiencing homelessness at some point in time. The intersection of homelessness and survivorship creates numerous barriers to care including safety concerns, stable housing, employment and childcare needs. The establishment of community institutional partnerships offers an opportunity to provide healthcare in transitional housing settings. AIMS: The aim of this paper is to discuss the need for community institutional partnerships in addressing the health needs of intimate partner violence survivors and provide a working example of an existing partnership. METHODS: A critical literature review of the literature was conducted. Multiple databases were searched to identify articles relating to health services, community institutional partnerships, intimate partner violence and sheltered housing. Articles were reviewed using The Johns Hopkins Nursing Evidence-Based Practice Quality Guide. FINDINGS: Three types of partnerships that can be leveraged to address the needs of individuals experiencing homelessness were identified: academic-community, hospital-community, and large-scale partnerships. Only one article was identified that focused on the health needs of survivors experiencing homelessness, pointing to the need for implementation of more community institutional partnerships to address the unique needs of homeless intimate partner violence survivors. We highlighted a current successful community institutional partnership that addresses the health needs of survivors living in an emergency shelter. IMPLICATIONS: Addressing the complex needs of this population is imperative to dismantle health inequities and structural barriers to healthcare. Holistic, nurse-led approaches to care are essential to address the health of intimate partner violence survivors experiencing homelessness. The example of a successful community institutional partnership provides a framework for delivering a wide range of healthcare services. Future nursing research is needed to evaluate programmes and provide foundational support for increased funding.

Passport to Freedom: A Trauma-Informed Mindfulness Program for Previously Incarcerated Women.

Poly-victimization is often reported by formerly incarcerated women and leads to physical and mental health problems that interfere with daily functioning, sustained employment, and housing stability. Although reentry programs exist, few focus on the physical and emotional impact of multiple traumas. Passport to Freedom (P2F), a woman-centered, trauma-informed reentry program, was developed to support formerly incarcerated women. The pilot intervention, performed in 2017, focused on the connections between trauma and health, coping with symptoms, and managing one's own health. To examine the effectiveness and feasibility of the intervention, we performed the current mixed methods study with two phases: (1) focus groups, and (2) sessions combining mindfulness and health promotion activities with follow-up evaluations. Participants (N = 24) showed decreased symptoms of depression and concerns of everyday stressors after the intervention. Of participants, 84% (n = 16) reported practicing mindfulness and 63% (n = 8) stated that mindfulness exercises helped with daily stress management. The P2F program offers a promising approach to support formerly incarcerated women with health self-management. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Honoring the past and charting the future: The International Society of Psychiatric Mental Health Nurses' commitment to advance diversity and equity in mental health care.

For more than two decades, the International Society of Psychiatric Nurses has dedicated its efforts to improving mental health care services worldwide, focusing on leveraging the psychiatric nursing workforce and advocating to eradicate systemic health disparities. Part of this labor included creating a culturally centered initiative, the Position Statement on Diversity, Cultural Competence and Access to Mental Health Care to fortify the cultural awareness of ISPN members to improve health-care quality delivered to diverse individuals, families, and communities across the life span and to improve these populations' access to mental health care.

House to house, shelter to shelter: experiences of black women seeking housing after leaving abusive relationships.

Locating safe and affordable housing is a vital step for women who decide to leave their abuser. Without housing, many women, particularly those who live in poverty, are forced to remain in abusive relationships, accept inadequate or unsafe housing, or become homeless (Menard, 2001; Moses, 2010). Women who choose to leave their abusers are faced with multiple barriers in establishing their independence such as limited financial resources, mental illness, and the lack of affordable housing (Botein & Hetling, 2010), putting them at risk of revictimization. This pilot study explores the narratives of Black mothers currently residing at an emergency intimate partner violence shelter to discover their experiences in seeking housing after leaving abusive relationships with a focus on housing instability and mental health. Utilizing a qualitative descriptive design, four major themes emerged: (a) unstable/insecure housing over time, (b) limited support,

Promoting nutrition in breastfeeding women.

Nurses have a vital role in providing nutritional education to breastfeeding women. In this article, the authors discuss the nutritional requirements for breast-feeding women in terms of micronutrients, macronutrients, and minerals. They provide recommendations for women with vegetarian diets and low-income women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children program who may have dietary deficiencies, and they present a directed case study to provide an example of how to perform a dietary assessment and the educational support that may be offered by nurses to breastfeeding women.