Perceived Success After Participation in the Summer Health Professions Education Program.

Importance: The number of active health care professionals has not kept pace with the increasing number of minoritized individuals in the US. The Summer Health Professions Education Program (SHPEP) was developed to alleviate this underrepresentation in the health workforce. Objective: To evaluate students' changes in perceived barriers and motivators for entering and succeeding in professional school after SHPEP participation. Design, Setting, and Participants: For this cohort study, anonymous electronic surveys were sent to the 2017 to 2021 SHPEP participants at an academic health center at a large university in the southern US. Participants were first- and second-year undergraduates interested in the health professions and enrolled in the SHPEP. Program participants were invited to complete the study. Exposures: An anonymous electronic survey was administered before and immediately after program completion. Main Outcomes and Measures: The SHPEP Career Barriers Survey (SCBS) is composed of 22 questions on motivators and 20 questions on barriers to entering and succeeding in health professional school. Students responded using a 5-point Likert scale, with 1 indicating strongly disagree and 5 indicating strongly agree. Mixed analysis of variance was used to analyze the program's latent factors. Results: Of all 402 SHPEP participants (mean [SD] age, 19.32 [0.88] years) from 2017 to 2021, 325 completed the preprogram survey and 259 also completed the postprogram survey. Of the 325 initial participants, 4 identified as American Indian or Alaska Native, Native Hawaiian, or Pacific Islander (1.2%); 12 as Asian (3.7%); 188 as Black (57.8%); 95 as Hispanic or Latino (29.2%); 7 as White (2.2%); and 16 as multiracial (4.9%). Two hundred twelve participants were female (65.2%), and 226 were first-generation college students (69.5%). Results of the SCBS indicate that the SHPEP had a significant small to moderate association on perceived motivators (mean [SD] x̅ = 84.60 [9.67] vs 80.95 [8.93]; P = .001) and decreases in perceived barriers (mean [SD] x̅ = 48.02 [13.20] vs 51.72 [11.39]; P = .008). There was no significant difference in program success between studied years. Conclusions and Relevance: In this cohort study, the SHPEP appeared to provide essential support for underrepresented students as measured by improved perceived motivators and reduced perceived barriers to entering professional education. Knowledge from this study can assist educators and health care professionals who wish to implement similar enrichment programs.

Strès ak Pwoblèm Pap Janm Fini: Deciphering migration-related stress from the perspectives of Haitian immigrants in Florida.

Relocating and starting a new life in a foreign country may entail a constellation of new stressors for Haitian immigrants; thus, research that enhances our understanding of how this vulnerable population contextualizes migration-related stress is necessary. The objectives of this study were to: (a) identify what factors are associated with migration-related stress, and (b) describe which and why specific migration-related stressors were most significant from the perspective of those suffering from high migration-related stress post migration via the stress proliferation lens of the stress process model. In this mixed-methods, sequential, explanatory pilot study, first-generation Haitian immigrants (N = 76) were recruited to operationalize migration-related stress, using the Demands of Immigration Scale (DIS). Participants (n = 8), who scored 25 or higher on the DIS, completed an in-depth audio-recorded follow-up interview that consisted of open-ended questions and a stressor-ranking questionnaire. Descriptive statistics, Pearson correlations, multiple linear regression (quantitative), and thematic analysis with a double-coded approach (qualitative) were employed to analyze the data. Female gender, older age, English fluency, and migration after the age of 18 years were associated with higher migration-related stress. However, only gender and English fluency predicted migration-related stress. In interviews, participants ranked five migration-related stressors as most stressful: language barriers, financial strains, loss of social networks, family conflicts, and exposure to discrimination/stigma. A nuanced depiction of migration-related stressors and proliferation mechanisms of migration-related stress may help identify areas where support and preventive efforts should be directed to improve social integration, stress levels, and mental well-being among immigrants.

"They're Not Willing To Accommodate Deaf patients": Communication Experiences of Deaf American Sign Language Users in the Emergency Department.

Deaf people who use American Sign Language (ASL) are more likely to use the emergency department (ED) than their hearing English-speaking counterparts and are also at higher risk of receiving inaccessible communication. The purpose of this study is to explore the ED communication experience of Deaf patients. A descriptive qualitative study was performed by interviewing 11 Deaf people who had used the ED in the past 2 years. Applying a descriptive thematic analysis, we developed five themes: (1) requesting communication access can be stressful, frustrating, and time-consuming; (2) perspectives and experiences with Video Remote Interpreting (VRI); (3) expectations, benefits, and drawbacks of using on-site ASL interpreters; (4) written and oral communication provides insufficient information to Deaf patients; and (5) ED staff and providers lack cultural sensitivity and awareness towards Deaf patients. Findings are discussed with respect to medical and interpreting ethics to improve ED communication for Deaf patients.

Achieving Health Equity Through Eradicating Structural Racism in the United States: A Call to Action for Nursing Leadership.

PURPOSE: To advocate for strategic actions by U.S. nursing leadership that denote the presence, customs, and implications of racism that has been institutionalized within the structures of U.S. nursing leadership and the profession. ORGANIZING CONSTRUCTS: A racial equity framework is used to examine the barriers to quality health care and equitable health outcomes and to present evidence-based actions to dismantle structural inequities embedded in the nursing profession. METHODS: This article was developed through a comprehensive literature review and synthesis of relevant research, data, peer-reviewed literature, government reports, and organizational guidelines. FINDINGS: A commitment by U.S. nursing leadership to eradicate structural racism in nursing must be made in order to effect sustainable transformative change toward more equitable systems of health care. CONCLUSIONS: This article presents recommendations for nursing leadership in the United States to renew its commitment to quality health care through dismantling structural racism at all levels of direct and systems nursing practice and education, at the bedside, and in the boardrooms. CLINICAL RELEVANCE: Structural racism in nursing and health care also persists globally as a key social determinant of health. Its elimination aligns with international health care and nursing's policy priorities, yet change can only occur when senior leaders clearly understand it as a key barrier to health, and commit to transformative change in how their "systems" work. These recommendations can also be culturally adapted by global nursing for use in antiracism work.

Stress and depression in the context of migration among Haitians in the United States.

Our global communities are becoming increasingly more diverse and interwoven; thus, research that enhances our understanding of the multidimensional relationship between depression and migration among distinct ethnic groups is imperative. This study examined the relationship between migration-related stress and depression and the extent to which that relationship is modified by other factors, through the lens of the stress process model. This cross-sectional pilot study used purposive sampling methods to recruit 76 first-generation Haitian immigrants living in South and West Florida from February 2018-May 2018. Descriptive statistics, bivariate and multiple regressions were utilized to assess associations among migration-related stress (Demands of Immigration Scale), depression (Center for Epidemiological Studies Depression (CESD), Zanmi Lasante Depression Symptom Inventory (ZLDSI)), and key demographic variables. Findings showed a strong positive correlation between migration-related stress and depression (CESD (ß =.606, 95% CI [.296, .556]) and ZLDSI (ß = .624, 95% CI [.242, .440]). Relative to the standardized coefficient, migration-related stress was the strongest predictor of depression after controlling for other predictors. Presence at the 2010 earthquake was the only significant moderator, showing an amplifying effect between migration-related stress and depression (ZLDSI) for those in Haiti during the 2010 earthquake. Consideration of pre-migration factors and the degree of migration-related stress encountered while adapting to life post-migration is critical because they play a significant role in shaping immigrants' depression realities. Community-based services that incorporate or partner with established immigrants to strengthen support for the most vulnerable immigrants early on after migration could serve to mitigate migration-related stressors and facilitate mental health promotion and prevention.

Esforços, sacrifícios e liderança heróicos: é tudo em um dia de trabalho para os enfermeiros antes, durante e após a crise do COVID-19 / Heroic efforts, sacrifices and leadership: it's all in a day's work for nurses before, during, and after the COVID-19 crisis / Esfuerzos heroicos, sacrificios y liderazgo: todo es un día de trabajo para las enfermeras antes, durante y después de la crisis de COVID-19

O novo coronavírus SARS-CoV-2 que surgiu na cidade de Wuhan, na China, no ano passado, produziu uma pandemia de coronavírus em larga escala (COVID-19). Enquanto escrevemos isso, em todo o mundo existem mais de um milhão de casos e o número de mortos chegou a mais de 100.000 pessoas. No Brasil e em outros países, alguns indivíduos teorizaram que o vírus foi "criado" em laboratórios, e alguns grupos religiosos levantaram a ideia de que o vírus sinalizava o início do apocalipse. No entanto, um estudo científico recente concluiu que o vírus é o produto da evolução natural, encerrando qualquer boato sobre engenharia genética deliberada. No Brasil, o COVID-19 foi diagnosticado pela primeira vez em 26 de fevereiro e já se espalhou por todos os estados e territórios.

The novel SARS-CoV-2 coronavirus that emerged in the city of Wuhan, China last year has produced a large-scale coronavirus (COVID-19) pandemic. As we are writing this, across the world there are more than a million cases, and the death toll has reached more than 100,000 people. In Brazil as well as other countries, some individuals theorized that the virus was "created" in laboratories, and some religious groups raised the idea that the virus signaled the onset of the apocalypse. However, a recent scientific study has concluded that the virus is the product of natural evolution, ending any rumor about deliberate genetic engineering. In Brazil, COVID-19 was first diagnosed on February 26th and has already spread throughout all the states and territories.

El nuevo coronavirus SARS-CoV-2 que surgió en la ciudad de Wuhan, China, el año pasado produjo una pandemia de coronavirus a gran escala (COVID-19). Mientras escribimos esto, en todo el mundo hay más de un millón de casos, y el número de muertos ha llegado a más de 100,000 personas. En Brasil, así como en otros países, algunas personas teorizaron que el virus fue "creado" en laboratorios, y algunos grupos religiosos plantearon la idea de que el virus señalaba el inicio del apocalipsis. Sin embargo, un estudio científico reciente ha concluido que el virus es el producto de la evolución natural, poniendo fin a cualquier rumor sobre ingeniería genética deliberada. En Brasil, COVID-19 fue diagnosticado por primera vez el 26 de febrero y ya se ha extendido a todos los estados y territorios.

EMBRACE: Developing an Inclusive Leadership Program With and for Undergraduate Nursing Students.

In order to meet the needs of an increasingly diverse patient population, nursing schools around the United States have been trying to recruit future nurses from a variety of racial/ethnic backgrounds, with limited success. To date, the literature does not describe how to develop culturally appropriate engagement models that can successfully transform minority nursing students into nurse researchers and leaders. Thus, the purpose of this article is to describe a promising research and leadership program for underrepresented undergraduate students entitled, "EMBRACE - Engaging Multiple-communities of BSN students in Research and Academic Curricular Experiences". More specifically, this article will: 1) describe the steps one College of Nursing has taken toward developing the EMBRACE program; 2) describe the theoretical framework developed for the program; and 3) present the initial challenges and positive outcomes of the program. The theoretical framework of the program is based on principles of excellence for diversity and inclusion as well as student and faculty engagement. The EMBRACE framework includes components of education, faculty contributions, social connections and emotional intelligence. The EMBRACE program consists of group mentoring with peers, one-on-one mentoring with faculty and graduate students, and working on a hands-on project relating to research or leadership.

Who and Where: A Socio-Spatial Integrated Approach for Community-Based Health Research.

Social and spatial characteristics of a population often interact to influence health outcomes, suggesting a need to jointly analyze both to offer useful insights in community health. However, researchers have used either social or spatial analyses to examine community-based health issues and inform intervention programs. We propose a combined socio-spatial analytic approach to develop a social network with spatial weights and a spatial statistic with social weights, and apply them to an ongoing study of mental and physical well-being of rural Latino immigrants in North Florida, USA. We demonstrate how this approach can be used to calculate measures, such as social network centrality, support contact dyads, and spatial kernel density based on a health survey data. Findings reveal that the integrated approach accurately reflected interactions between social and spatial elements, and identified community members (who) and locations (where) that should be prioritized for community-based health interventions.

The emergence of team science: Understanding the state of adoption research through social network analysis.

The notion of team science has recently gained popularity in European and American health sciences considering increasing evidence that scientific collaboration produces higher-impact research and that complex scientific problems are better investigated by interdisciplinary teams. While publication metrics indicate adoption research is expanding, the comprehensive structure of adoption studies as a scientific field has not been formally evaluated for collaborative and cross-disciplinary activity. This article aims to elucidate the structure, composition, and dynamics of scientific relationships within adoption research that may inform research and practice strategies, competencies, and cohesion within the field. Using social network analysis, we extracted bibliographic data on 2767 peer-reviewed adoption-related articles from 1930s to 2014 and evaluated the resulting co-authorship and co-citation networks. We found that adoption research has grown substantially over the last 25 years, and is conducted in varied disciplines, with increasing collaboration across geography and disciplinary areas. The co-authorship and co-citation networks are approaching numeric thresholds and structural configurations distinctive of well-established and more institutionalized fields of study. These findings reveal the maturation of adoption studies as a team science and argue for the development of institutional mechanisms that support such evolution. Implications for professional and research planning are discussed.

Review of the Literature: A Rural-Urban Comparison of Social Networks of Older Adults Living With HIV.

Globally, aging populations and older persons living with HIV (OPLWH) are emerging socioeconomic and health care concerns. Aging adults living in rural communities have less access to and lower utilization of health care services; they rely heavily on available peer and family networks. Although social networks have been linked to positive mental and physical health outcomes, there is a lack of understanding about social networks in rural-dwelling OPLWH. The purpose of this integrative literature review was to compare emerging themes in the social network components of rural versus urban-dwelling OPLWH and network benefits and barriers. Overarching themes include: limited and/or fragile networks, social inclusion versus social isolation, social capital, and health outcomes. Results demonstrate an overall lack of rural-focused research on OPLWH and a universal lack of informal and formal networks due to isolation, lack of health care services, and omnipresent HIV stigma.

FBO Leaders' Perceptions of the Psycho-social Contexts for Rural Latinos.

Latinos comprise the largest minority rural population in the US, and they are often exposed to adverse social health determinants that can detrimentally affect their mental health. Guided by community-based participatory research (CBPR) principles, this study aimed to describe faith-based organizations (FBOs) leaders' perceptions of the contexts affecting the mental well-being of rural Latino immigrants and potential approaches to mental health promotion for these immigrants. This is a descriptive, qualitative arm of a larger study in which community-academic members have partnered to develop a culturally-tailored mental health promotion intervention among rural Latinos. FBO leaders (N = 15) from different denominations in North Florida were interviewed until saturation was reached. FBO leaders remarked that in addition to religiosity, which Latinos already have, more community building and involvement are necessary for the promotion of mental health.

An individual-based rurality measure and its health application: A case study of Latino immigrants in North Florida, USA.

Rurality has been frequently noted by researchers as pathways to understand human health in rural and remote areas. Current measures of rurality are mostly oriented to places, not individuals, and have not accounted for individual mobility, thus inappropriate for studying health and well-being at an individual level. This research proposed a new concept of individual-based rurality by integrating personal activity spaces. A feasible method was developed to quantify individuals' rural experience using household travel surveys and geographic information systems (GIS). For illustration, the proposed method was applied to understand the well-being and social isolation among rural Latino immigrants, who had participated in a community-based participatory research (CBPR) study in North Florida, USA. The resulting individuals' rurality indices were paired with their scores of well-being and social isolation to identify potential associations. The correlation analysis showed that the proposed rurality can be related to the social isolation, mental and physical well-being of individuals in different gender groups, and hence could be a suitable tool to investigate rural health issues.

Clinical Implications of Family-Centered Care in Stroke Rehabilitation.

PURPOSE: Most stroke survivors will be cared for at home by family caregivers with limited training. Families actively involved in rehabilitation feel more prepared for the new responsibilities of caring for the stroke survivor. The focus of this article is to highlight the relevant concepts of a family-centered model of care and provide general guidance on how integrating a family-centered mindset may be clinically applicable. DESIGN: Concept Analysis. METHODS: Synthesis of literature on family-centered care and its application in for rehabilitation nurses. FINDINGS: Family-centered care is a model of collaborative healthcare that encourages collaboration and partnership among patients, families, and providers with respect to the planning, delivery, and evaluation of health care. Care provided within such a model can expand providers' knowledge of the impact of illness and any issues that may affect eventual transition back home. CONCLUSION: Rehabilitation nurses should view stroke patients and family caregivers as a unit. Using family-centered strategies can help nurses provide appropriate, individualized care during rehabilitation.

Rural Latinos' mental wellbeing: a mixed-methods pilot study of family, environment and social isolation factors.

Upon immigration to the rural areas in the US, Latino families may experience cultural, geographic, linguistic and social isolation, which can detrimentally affect their wellbeing by acting as chronic stressors. Using a community engagement approach, this is a pilot mixed-method study with an embedded design using concurrent qualitative and quantitative data. The purpose of this study is to evaluate family and social environments in terms of protective factors and modifiable risks associated with mental well-being in Latino immigrants living in rural areas of Florida. Latino immigrant mother and adolescent dyads were interviewed by using in-depth ethnographic semistructured interviews and subsequent quantitative assessments, including a demographic questionnaire and three structured instruments: the Family Environment Scale Real Form, the SF-12v2™ Health Survey and the short version (eight items) of PROMIS Health Organization Social Isolation. This mixed-method pilot study highlighted how family, rural, and social environments can protect or impair wellbeing in rural Latino immigrant mother and adolescent dyads.

I Didn't Ask to Come to this Country I was a Child: The Mental Health Implications of Growing Up Undocumented.

Growing up as an undocumented immigrant and transitioning to "illegal" adulthood can expose the person to adverse social determinants, which can detrimentally affect mental health by acting as chronic stressors. Although there have been several attempts to reform immigration, none have been entirely successful. Recently, the Dream Act and the path toward citizenship may be important steps for reducing mental health disparities among the undocumented, immigrant population. This case report will describe the experiences of one Latino "dreamer", reveal the effects of an undocumented status on mental health, and posit future directions for mental health promotion in this vulnerable population.

Promotoras in mental health: a review of English, Spanish, and Portuguese literature.

Promotoras have worked in various areas of public health; however, there is a lack of understanding about their work in mental health. This article reviews the literature in 3 different cultures/languages (English, Spanish, and Portuguese) and aims to describe promotoras' roles, training, and interventions and their outcomes related to mental health activities. Results demonstrate that in different cultures/languages, promotoras empower community members to promote mental health and prevent exacerbation of individuals' mental illness. Promotoras, when trained carefully, have the ability to increase awareness and to promote mental health in populations that would otherwise have limited or no access to care.

CBPR: building partnerships with latinos in a rural area for a wellness approach to mental health.

Using Community-Based Participatory Research, this study describes the ongoing collaboration between Latino community leaders and academic partners to develop a mental health promotion intervention for rural Latinos in Florida. Two strategies were used: (1) Community Advisory Board (CAB) members completed a Latino Community Partners Survey (LCPS) and (2) scribe notes were taken during CAB meetings. The LCPS demonstrated not only the CAB's knowledge about the community but the readiness of leaders to get involved in the community-academic partnership. Thematic analysis of scribe notes revealed four main categories: caring, knowledges, interpersonal dynamics, and future impact in the community. CAB members greatly enhanced academic partners' understanding of the community's needs as well as of their own culturally-specific knowledge.

Review: Community-based participatory research approach to address mental health in minority populations.

In this review, a synthesis of studies employing community-based participatory research (CBPR) to address mental health problems of minorities, strengths and challenges of the CBPR approach with minority populations are highlighted. Despite the fact that minority community members voiced a need for innovative approaches to address culturally unique issues, findings revealed that most researchers continued to use the traditional methods in which they were trained. Moreover, researchers continued to view mental health treatment from a health service perspective.

Comparison of depressive symptom severity scores in low-income women.

BACKGROUND: The Beck Depression Inventory, Second Edition (BDI-II), and the Patient Health Questionnaire-9 (PHQ-9) are considered reliable and valid for measuring depressive symptom severity and screening for a depressive disorder. Few studies have examined the convergent or divergent validity of these two measures, and none has been conducted among low-income women-although rates of depression in this group are extremely high. Moreover, variation in within-subject scores suggests that these measures may be less comparable in select subgroups. OBJECTIVE: We sought to compare these two measures in terms of construct validity and to examine whether within-subject differences in depressive symptom severity scores could be accounted for by select characteristics in low-income women. METHODS: In a sample of 308 low-income women, construct validity was assessed using a multitrait-monomethod matrix approach, between-instrument differences in continuous symptom severity scores were regressed on select characteristics using backward stepwise selection, and differences in depressive symptom classification were assessed using the Mantel-Haenszel test. RESULTS: Convergent validity was high (rs = .80, p < .001). Among predictors that included age, race, education, number of chronic health conditions, history of depression, perceived stress, anxiety, and/or the number of generalized symptoms, none explained within-subject differences in depressive symptom scores between the BDI-II and the PHQ-9 (p > .05, R2 < .04). Similarly, there was consistency in depressive symptom classification (χ2 = 172 and 172.6, p < .0001). DISCUSSION: These findings demonstrate that the BDI-II and the PHQ-9 perform similarly among low-income women in terms of depressive symptom severity measurement and classifying levels of depressive symptoms, and do not vary across subgroups on the basis of select demographics.