HPV Vaccine Communication Competency Scale for Medical Trainees: Interdisciplinary Development Study.

BACKGROUND: Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States. High-risk HPV strains are associated with cancer of the cervix, oropharynx, anus, rectum, penis, vagina, and vulva. To combat increasing HPV-related cancers, the 9-valent HPV vaccine Gardasil was developed. Recommendation of the HPV vaccine by a health care provider has been cited as the number one factor affecting vaccine uptake among adolescents and young adults. Physician assistants, nurse practitioners, and pharmacists have been enlisted to bridge the gap. OBJECTIVE: The specific aim of this research study was to develop a reliable and valid HPV vaccine communication scale that can be used to measure the competency of primary care providers when recommending the need for vaccination to parents and patients. METHODS: Using a descriptive study, we collected data via a literature review, focus groups, and an expert panel to inform the scale domains and blueprint design. Pretesting (cognitive interviews) was used to inform item revision decisions. An item analysis was also conducted for the responses provided in the cognitive interviews. Item statistics (means and SDs), interitem correlations, and reliability were examined. Data were analyzed using SPSS (IBM Corp) software. RESULTS: A valid and reliable 42-item HPV vaccine communication competency scale was developed. The scale included 6 domains of interest. Scale items were moderately to strongly correlated with one another, and Cronbach α indicated good internal consistency with each scale. Scale items included were related to provider introduction or rapport (α=.796), patient respect or empathy (α=.737), provider interview or intake (α=.9), patient counseling or education (α=.935), provider communication closure (α=.896), and provider knowledge (α=.824). CONCLUSIONS: Pharmacists, nurse practitioners, and physician assistants should be trained to be competent in HPV vaccine communication and recommendation due to their expanded roles. Interdisciplinary collaboration is important to account for the trainee's individual differences and ensure the best health care outcomes for patients. A standardized HPV communication scale can be used to ensure effective and consistent recommendation by health care providers, thus affecting immunization rates.

Confirmatory Factor Analysis of MUIS-C Scale Among Baby Boomers With Hepatitis C.

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate Mishel Uncertainty in Illness Scale-Community (MUIS-C), used to gauge level of uncertainty among baby boomers with hepatitis C virus (HCV) infection, as a reliable two-factor instrument. METHODS: A CFA was conducted to test MUIS-C. There were minor deviations from normality. Subsequently, 130 participants were used to examine the factor structure and the model fit. A robust maximum likelihood (ML) estimation using the Wishart distribution was implemented in R version 3.3.1. RESULTS: A very good model fit was obtained (χ2(101) = 118.32, p = .115, TLI = 0.977, CFI = 0.983, RMSEA = 0.036, 90%CI(0.000, 0.061), and SRMR = 0.057). All indicators showed significant positive factor loadings, with standardized coefficients ranging from 0.511 to 0.868. CONCLUSIONS: The MUIS-C was a reliable two-factor instrument and suitable for use as such in baby boomer population with HCV.

An interprofessional education approach to fall prevention: preparing members of the interprofessional healthcare team to implement STEADI into practice.

An aging population benefits from healthcare providers trained in the care of older adults. Interprofessional education (IPE) and service-learning activities focused on geriatric conditions like falls may address this need. A fall prevention IPE activity using the Centers for Disease Control and Prevention (Stopping Elderly Accidents, Deaths & Injuries (STEADI) initiative was implemented to prepare health sciences students to manage older adult falls. Students (N = 31) and faculty (N = 10) from five health sciences programs and local older adults (N = 27) participated. Students were trained in STEADI and conducted a fall risk screening, assessment, and intervention activity with older adults using STEADI tools. We observed a statistically significant improvement in student knowledge of fall prevention and STEADI as assessed by pre and postactivity measures. Student surveys indicated improved understanding of the roles and responsibilities of participating disciplines, related to management of falls in older adults. The CDC's STEADI initiative may provide an effective framework and resources for fall prevention IPE activities and geriatric health sciences education.

Mitigating fall risk: A community fall reduction program.

One fourth of all American's over 65 years of age fall each year. Falls are a common and often devastating event that can pose a serious health risk for older adults. Healthcare providers are often unable to spend the time required to assist older adults with fall risk issues. Without a team approach to fall prevention the system remains focused on fragmented levels of health promotion and risk prevention. The specific aim of this project was to engage older adults from the community in a fall risk assessment program, using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) program, and provide feedback on individual participants' risks that participants could share with their primary care physician. Older adults who attended the risk screening were taking medications that are known to increase falls. They mentioned that their health care providers do not screen for falls and appreciated a community based screening.

Transformational Leadership: A Model for Advanced Practice Holistic Nurses.

Advanced Practice Holistic Nurse (APHN) leaders could provide a model of leadership to advance value based health care systems in the United States. The American Nurses Association has recognized Holistic Nursing as a specialty because of the emphasis placed on patient-centered care, the development of therapeutic relationships, interconnection, and holism. Transformational leadership is a framework that uses vision, inspiration and intellectual stimulation to motivate people toward needed change. The APHN is well positioned to use transformational leadership methods to lead teams placing the patient at the center of health care decision making and bring the essence of holism to the forefront of health care. Highlighted are methods for positive communication, inspiration, negotiation, and conflict resolution as tools the APHN could use to become a transformational leader. The purpose of this article is to discuss a framework for transformational leadership development and implementation to establish the holistic ideals of APHNs in the health care system.

Examining the factor structure of MUIS-C scale among baby boomers with hepatitis C.

BACKGROUND: Baby boomers account for two out of every three cases of hepatitis C infection in the U.S. PURPOSE: To conduct an exploratory factor analysis directed at supporting the use of the MUIS-C as a reliable instrument in measuring illness uncertainty among baby boomers with hepatitis C. METHODS: The steps of conducting a typical principal component analysis (PCA) with an oblique rotation were used on a sample of 146 participants, the sampling adequacy of items was examined via the Kaiser-Meyer-Olkin (KMO) measure, and the Bartlett's sphericity test was used for appropriateness of conducting a factor analysis. RESULTS: A two-factor structure was obtained by using Horn's parallel analysis method. The two factors explained a cumulative total of 45.8% of the variance. CONCLUSIONS: The results of the analyses indicated that the MUIS-C was a valid and reliable instrument and potentially suitable for use in baby boomer population diagnosed with hepatitis C.