Social entrepreneurship and public health nursing knowledge: Opportunities for innovating nursing education in population health.

Public health nursing (PHN) competencies are fundamental for addressing population health inequities. Few pathways exist for employing these competencies in the United States (US). Social entrepreneurship in nursing education might provide opportunities for innovating engagement in population health. Partnerships between business and nursing schools have the potential to fulfill this opportunity. PURPOSE: Explore opportunities for re-invigorating public health nursing through social entrepreneurship education in nursing-business partnerships in U.S. universities. METHODS: Reviewed programs in nursing/business school partnerships from Carnegie-classified R1 Universities. Identified appropriate coursework. RESULTS: Of 96 identified nursing schools, eight had business school partnerships, providing 12 programs. Most programs (n = 11) targeted graduate students and addressed core competencies for entrepreneurship. Five business schools had entrepreneurship expertise. Five nursing schools had PHN expertise. Three programs included population health competencies. DISCUSSION: Despite missed opportunities for advancing social entrepreneurship education among undergraduate and graduate nursing students, existing curricular offerings in the partnerships provide promise. Business/nursing partnerships and PHN knowledge can stimulate the preparation and agency of nurses in addressing population health inequities.

Use of telehealth simulation to teach the enhanced primary care RN role through community/public health-focused simulations.

America is facing a primary care provider shortage. Enhanced primary care RNs (EPC-RNs), registered nurses working at the top of their practice scope, can be an important part of community-based primary care provision. Typically, community health nursing education has not included primary care-based clinical experiences, and there is a clinical site shortage. Teaching students about EPC-RN roles can be an important domain of community/public health nursing education. Simulation is a creative pedagogical approach to learning about the EPC-RN role. The purpose of this manuscript is to 1) describe EPC-RN Telehealth Simulation development; and 2) describe student simulation feedback. Nursing faculty and simulation experts designed five simulations for community health students to teach about the EPC-RN role, incorporating recommendations from the Quad Council Coalition of Public Health Nursing Organizations community/public health nursing competencies and the National Competencies for Registered Nurses in Primary Care. Retrospective, descriptive quantitative, and qualitative student feedback data (n = 519) was collected through QuestionPro over multiple semesters. Student feedback data demonstrated support of the use of the simulations in community/public health nursing education. The EPC-RN Telehealth Simulations prepared pre-licensure nursing students to practice in community-based primary care settings. Innovative, sustainable experiences such as this can improve community/public health nursing education.

Broadcast health: Leveraging YouTube for community health education.

OBJECTIVE: In community health, there is great demand but limited time for the delivery of staff and patient education. During the COVID-19 pandemic, evolving needs necessitated that health education be provided in an accurate and timely manner. This paper describes the development, implementation, and evaluation of a YouTube channel designed to disseminate health education to a wide audience of public health workers and patient populations. METHODS: This project, divided into three phases, originated within shelter-based care, providing education to shelter staff (Phase 1) and overtime has evolved to provide education within the Community Health Worker Hub at a major teaching hospital for community health workers (Phase 2) and the populations they serve (Phase 3). Further, during phase 3, the project developer used an artificial intelligence (AI) platform to increase the reach of the YouTube channel. RESULTS: Over a span of 21 months, 18 unique videos have garnered 489 views. CONCLUSIONS: Clinicians and educators can leverage technology platforms for health education delivery, increasing the reach of their work while meeting the demands of the profession. While the quality of some information on YouTube may be poor, patients and students turn to this platform for health education. It is imperative that public health nurses embrace this medium, rather than push against it. By creating high-quality content, educating students and patients about DISCERN and PEMAT tools, and guiding patients to credible sources, public health nurses may ameliorate the standards of health education on YouTube.

Creating a quadruple aim model for nursing education.

Baccalaureate nursing education is moving to adopt the new American Association of Colleges of Nursing Essentials for Professional Nursing Education. As identified in two of the six domains of the essentials, graduates need to be prepared to address population health and utilize informatics and healthcare technologies. Community/public health nursing also has eight domains for generalist nurses linked to population health which will help prepare a skilled nursing workforce for the 21st century. The Institute for Healthcare Improvement's Triple Aim which evolved into the Quadruple Aim is focused on improving health outcomes within healthcare delivery. Through a literature review, a need for a Quadruple Aim model for nursing education was identified. Mirroring the Institute for Healthcare Improvement's Triple Aim for healthcare delivery, a Quadruple Aim for Nursing Education Model was developed. The model dimensions include (1) Population-focused Care, (2) Maximize Student Learning Experience, (3) Cost-effective Pedagogy, and (4) Nurse Educator Well-being. The Quadruple Aim for Nursing Education Model supports nursing education to prepare future nurses effectively and efficiently bridging population health concepts and issues with nursing informatics. Nurse educators are encouraged to utilize the model to transform nursing education.

Hepatitis B immunity among undergraduate nursing students: A brief report.

BACKGROUND: Health sciences students who report low/equivocal hepatitis B titers may be required to repeat the immunization series, even though the result may not indicate non-immunity. METHOD: To describe hepatitis B immunity patterns, this retrospective, descriptive study utilized de-identified vaccination records and anti-HBs titers of three cohorts of sophomore nursing students entering clinical rotations in 2018-2019. RESULTS: Only 33% of students had initial anti-HBs quantitative serum titer ≥10 mIU/ml, demonstrating immunity. After students with low/equivocal titers (n = 191, 64%) were re-immunized per institution protocol, only 2% (n = 7) were identified as non-responders. Cumulative costs incurred by students for revaccination and repeat titer exceeded $20,000, with a process time of up to 8 months. CONCLUSION: While rates of exposure to hepatitis B in acute care settings have steadily declined in the United States, students who go on to practice in community and public health settings have increased risk of exposure. Following best practices in demonstrating hepatitis B immunity, which include a single challenge dose followed by titer 4 weeks later, would decrease per student costs, wait time, and administrative burden associated with documentation and student counseling.

Difficulties in providing genetic consultations by public health nurses in Japan.

OBJECTIVE: The objectives of this study were to identify the topics that Japanese public health nurses (PHNs) find difficult during genetic consultations and to identify the relationships between these difficulties and PHNs' genetic education. METHODS: We conducted a mail survey delivered to PHNs employed by local Japanese governmental agencies in the Tokyo metropolitan area, between July and October 2015. The self-administered questionnaire queried the (1) experience with genetic consultation, (2) perceived difficulties in genetic consultation, (3) genetics education background, and (4) demographics. The association between the perceived difficulties in genetic consultations and the genetics education opportunities was examined using logistic regression. RESULTS: Of the 907 mailed surveys, 536 PHNs responded (59.1% response rate). Most of the respondents (89.7%) had previously conducted genetic consultations. The majority of respondents (72.7%) had partaken in consultations regarding a possible hereditary disorder in the client or their families, and of those, 76.6% perceived difficulties during the genetic consultation. Respondents who had previously studied decision-making support for genetic testing were significantly less likely to perceive difficulties in genetic consultations on prenatal diagnosis (OR = 0.04, 95% CI [0.00-0.73]). CONCLUSIONS: Our results suggest that PHNs receive training in genetic consultation, which can be integrated into everyday practice.

COVID-19 vaccine inquiries regarding children ages 5-11 years received by NIP-INFO.

We describe COVID-19 immunization inquiries regarding children age 5-11 years received by NIP-INFO, the Centers for Disease Control and Prevention's (CDC's) e-mail immunization inquiry service for health care professionals, at the launch of vaccination efforts for this age group, using descriptive qualitative analysis. From November 2 through November 30, 2021, NIP-INFO responded to 154 questions regarding COVID-19 vaccination for 5-11-year-old children. The most common questions related to formulation and dosage (39.6%), vaccination schedule (14.3%), CDC's educational materials for health care professionals (9.1%), and vaccine safety (8.4%); 16.2% of questions across all inquiry categories related to a vaccination error. We discuss CDC guidance related to the most common inquiries to inform further pediatric COVID-19 vaccination efforts, including future vaccination of younger pediatric age groups, which will be important to help to curb this pandemic.

A holistic health determinants model for public health nursing education and practice.

Baccalaureate nursing graduates (BSNs) in the 21st century need to be prepared to manage the population health needs of diverse populations across the lifespan and take actions to improve health equity. A need for a Holistic Health Determinants Model that included the Social Determinants of Health was identified. A model incorporating the Healthy People 2020 Health Determinants Model and the Healthy People 2030 Social Determinants of Health Model was developed. Two theoretical approaches provided a foundation for the model. Social ecological theory stresses the lived experience in an ever-changing environment from the micro to the macro biological, behavioral, social and physical environmental levels. Public health intersectionality added the construct of constant interactions among the health determinants that resulted in different levels of health status among individuals and groups. This Holistic Health Determinants Model is a tool to use in teaching nursing students how to address the needs of individuals/families, diverse populations, and communities. It also facilitates integration of the new AACN Population Health Competencies across the curriculum. The model facilitates the preparation of BSN graduates to address the factors that shape health status and to take actions to improve health equity.

An analysis of Norwegian public health nursing curricula: Where is the nursing literature?

BACKGROUND: Norwegian public health nurses prevent diseases and promote health in children and young people aged 0-20 and their families. Public health nursing programs prepare students for their practical role and provide relevant theoretical knowledge. OBJECTIVES: To gain knowledge of the literature in the Norwegian public health nursing curricula, and to examine further the nursing base in these curricula. DESIGN: An explorative and descriptive design was chosen. SAMPLE: Reading lists based on syllabus documents from the 10 higher educational institutions in Norway offering programs in public health nursing. MEASUREMENTS: A summative content analysis and a categorization of content from reading lists were performed. RESULTS: Numerical information on the content and categorization of reading lists shows that social science and humanities literature dominates, followed by psychology and medicine. Nursing texts, theories and philosophy comprise only a minor part of the curricula. CONCLUSION: The paper provides valuable data on the theoretical focus in Norwegian public health nursing and raises important questions about the paucity of nursing texts in the curriculum. The imbalance in reading lists in Norway should be studied further and similar studies conducted in other countries to encourage reflection on the theoretical content of public health nursing education globally.

Flipping the Classroom: Incorporating Video Production in Public Health Nursing Education.

A video production activity utilizing a flipped-classroom approach was used in a public health nursing course to educate undergraduate nursing students about infectious diseases. After reviewing an audio-recorded lecture at home, students were divided into small groups to create short video clips on selected infectious diseases. Four themes emerged from the subsequent participant survey: engagement, in-depth understanding but concerns for new knowledge acquisition, practical, and room for improvement. The flipped classroom approach with video production encouraged students to engage in their public health nursing class and provided them with an opportunity to practice important communication skills.

The application of health behavior theories to promote cervical cancer screening uptake.

BACKGROUND: While cervical cancer is a major cause of mortality, its progress and survival rate can be improved through screening. Yet despite their wide availability, women's participation in cervical cancer screening (CCS) programs is often suboptimal, especially in low- and middle-income countries. Besides demographic and organizational characteristics, screening uptake is influenced by psychological factors, most of which are included in health behavior theories. This systematic review compared different health behavior theories in terms of their capacity to explain CCS uptake and inform CCS promotion campaigns. METHODS: A comprehensive search and analysis of published intervention and non-intervention (observational) studies that applied at least one health behavior theory to CCS participation. RESULTS: After quality screening, 48 observational and 21 intervention studies were identified that applied the Health Belief Model (HBM), Theory of Reasoned Action (TRA), Theory of Planned Behaviour (TPB), Transtheoretical model (TTM), Social-ecological Model (SEM), and/or Theory of Triadic Influence (TTI) to CCS. The HBM was most frequently used to explain behavior, whereas the TPB was better at explaining screening intentions. Tailored intervention studies focusing on all theoretical constructs were most effective in modifying perceptions and increasing CCS uptake. CONCLUSIONS: Despite their inconsistent use, health behavior theories can explain CCS intentions and behavior and contribute to the development of targeted interventions to promote screening uptake.

Faculty perspectives on transitioning public health nursing clinical to virtual in response to COVID-19.

The COVID-19 pandemic has highlighted the need for public health nursing as an integral part of a strong public health workforce. However, it has also created challenges in preparing future nurses as much of nursing instruction, including clinical experiences, needed to urgently transition learning to a virtual environment. This paper describes the process faculty experienced during spring 2020 to quickly transition public health nursing clinicals from in-person to virtual learning in response to COVID-19. Further, faculty lessons learned are shared and include the importance of creating a supportive team dynamic, embracing innovation, continuing to engage with community partners, and adapting to meet emerging student needs during the evolving pandemic. The process and lessons learned may act as a guide for other nursing programs as we continue to navigate nursing education during this and future pandemics.

A strengths, weaknesses, opportunities, and threats analysis- A study of Association of Community/Public Health Nursing Educators members.

OBJECTIVE: Aims of this study were to identify the Association of Community/Public Health Nursing Educators members' demographics, educational preparation, and research competencies; and, to complete a strengths, weaknesses, opportunities, and threats (SWOT) analysis. METHODS: A descriptive-correlational design was employed. Primary data collection was via electronic survey. Authors developed a survey focusing on demographics and aligning Benner's theory with research skills/experience. SWOT and gap analyses were performed. RESULTS: A 27.2% response rate (N = 352) revealed a lack of diversity among 70% doctorally prepared membership, perceived competence with interprofessional collaboration (80%), and applying research to practice (80%). Doctorally prepared members reported experience using longitudinal designs (p = .05). PhD-prepared members reported experience using psychometrics and evaluations (p = .05). SWOT revealed a lack of service engagement. Gap analysis offered solutions to execute strategic goals. CONCLUSIONS: Association of Community/Public Health Nursing Educators may enhance future direction by advancing member diversity, professional development, collaborative scholarship, and mentoring.

Academic practice partnerships: A review of a statewide population health nursing leadership initiative.

OBJECTIVE: In 2012, the state public health nurse (PHN) Leaders Workgroup formed with members from the state PHN Administrators organization and PHN faculty to facilitate the development of statewide PHN Academic practice partnerships (APP's). In 2016, the workgroup received a state Nurses Foundation grant for $6,000 followed by $5,000 in 2017 to fund the first 2 years of APP projects. DESIGN: The workgroup disseminated two calls for proposals to the Deans of state academic nursing institutions and local health department leaders, utilizing an application adapted from the American Association of Colleges of Nursing (AACN) APP Toolkit. Selection criteria included project intent; partner support; anticipated outcomes; budget; geographic location; and alignment with the Robert Wood Johnson Foundation (RWJF) Culture of Health framework. SAMPLE AND RESULTS: Sixteen proposals were received and reviewed by workgroup members resulting in 10 funded pilot projects. In 2018, the workgroup was awarded $55,980 from the RWJF to expand this initiative; funding an additional 10 APP's to date. Partnerships were reported as valuable by students, faculty, and practice partners. Barriers included provider participation, adherence to project timelines, communication, and the navigation of group dynamics. CONCLUSION: Academic practice partnerships positively impact patient outcomes, patient satisfaction, nursing outcomes, and student learners.

Supporting food literacy among children and adolescents: Undergraduate students apply public health nursing principles in clinical practice.

Effective public health nurses excel in partnership building and program planning to address priority health concerns, such as childhood obesity and disordered eating. Worldwide, children are at risk for low food and nutrition literacy with associated patterns of low fruit and vegetable consumption. This report focuses on the application of public health nursing principles by undergraduate nursing student teams in the design and delivery of food literacy interventions among a population of children and adolescents. Over a four-year time period, the cumulative intervention reach was 640 children/adolescents. Over 75 nursing students implemented the public health nursing process in support of food literacy, gaining skills across multiple practice domains. Lessons learned from academic-community partnerships to promote food literacy among children and adolescents have direct implications for undergraduate nursing education. Chief among these implications include the growing significance of integrating nutrition in the nursing curriculum and the need for scaffolding to support clinical application of interventions beyond health teaching to address broad determinants of health.

Transforming learning: Applying community and systems level interventions through a poster project.

BACKGROUND: Public health nursing practice is population-focused with a goal of improving health outcomes. Nurse educators are challenged to identify teaching-learning strategies to transform students' perspectives and knowledge of public health concepts. PURPOSE: The purpose of the poster project was to evaluate students' ability to meet Quad Council Coalition Competency Review Task Force competencies for public health nursing. METHODS: Teams of students identified an issue, investigated epidemiological data, searched literature, linked the issue to a Healthy People 2020 objective, defined the societal health construct, identified evidence-based interdisciplinary actions, and drew a conclusion based on the synthesis of evidence. The Quad Council Public Health Nursing domains and competencies provided a crosswalk design for faculty to evaluate teams' ability to plan and implement population-focused actions within the poster project. RESULTS: Teams met one or more competencies in six out of eight domains. Domains I-IV, VI, and VIII were met by 100%, domain V was met by 60%, and domain VII was met by 25% of the teams. DISCUSSION: Ownership of the poster translated into teams demonstrating creative approaches and expertise in identifying actions to address societal health outcomes. CONCLUSION: The societal health construct poster is an effective pedagogical approach that encourages teams to become change agents at the community and systems level.

Development and testing of a practicum matching program for baccalaureate nursing education, a local public health unit.

This article describes a novel approach to nursing education, designed to improve the experience of both students in public health nursing, and the local public health unit where they affiliate. Students, faculty, and public health department staff developed a method for matching programs and needs of the local public health unit to the skills and learning needs of nursing students. We describe our experience articulating student competencies, program-specific functions, and an approach to matching student interests and learning opportunities to agency needs. Students, faculty, and staff rated the program moderately to very high in feasibility, satisfaction, and acceptability. Data suggest the novel program served to improve the quality of the practicum affiliation, to the satisfaction of both the school and agency, while contributing to a robust public health learning experience for emerging professional nurses.

An experiential approach to developing radiological content for public health nursing: Lessons from a nuclear disaster.

OBJECTIVE: This study identified the radiological content required for PHNs and public health nursing students based on PHNs' experiences caring for people affected by the 2011 Fukushima Daiichi nuclear power plant accident. DESIGN: We used qualitative research, interviews, and content analysis. SAMPLE: Participants were eight PHNs employed by local governments in Fukushima and neighboring prefectures. RESULTS: Six content themes regarding the nuclear disaster were identified: (a) basic knowledge about radiation, (b) public health nursing activities in emergency exposure situations, (c) management in emergency exposure situations, (d) consultation to support residents affected by the nuclear disaster, (e) activities in the existing exposure situations, and (f) disaster preparedness in the planned exposure situations. Necessary content shifted depending on the phase of the nuclear disaster recovery. CONCLUSIONS: The use of the experiences of PHNs after the nuclear power plant accident to inform PHNs and public health nursing students will enable PHNs to respond appropriately and support people without difficulties. Comprehensive radiation content is needed to address the range of situations caused by nuclear disaster.

Health visitors' competences before and after implementing the newborn behavioral observations (NBO) system in a community setting: A cluster randomised study.

OBJECTIVE: To explore differences between health visitors' competences before and after implementing the newborn behavioral observations (NBO) system in four Danish municipalities. DESIGN AND SAMPLE: In a cluster randomized design, 56 and 55 health visitors were enrolled in the intervention and comparison districts. Only health visitors from the intervention district received the NBO education programme. MEASUREMENTS: Data from self-administered questionnaires on heath visitors' intention, self-efficacy, knowledge, and observation skills were collected before and after NBO training. Data were analysed using descriptive and multivariable analyses. RESULTS: Health visitors reported high levels of intention, self-efficacy, and knowledge working with early parent-infant relationships in both groups at baseline. After implementing NBO, the intervention health visitors reported a significantly higher level of knowledge of infant self-regulation than the comparison group. No significant differences were found in health visitors' level of intention and self-efficacy working with early parent-infant relationships, or in health visitors' observation skills assessing the quality of early relationship. CONCLUSIONS: Health visitors attending the NBO education and working with NBO in clinical practise had a significantly higher level of knowledge of infant self-regulation. A new discussion of how to educate health visitors' competencies working with early relationship in clinical practise is needed.

When reach exceeds touch: Student experiences in a cross-sector community-based academic-practice partnership.

OBJECTIVE: A partnership between three nursing programs, multiple high-needs public school districts and a local asthma coalition was developed as a way to build shared capacity aimed at improving health outcomes for children with asthma. This article explores student perceptions of their clinical experiences teaching asthma self-management within a regional cross-sector, community-based, multi-site academic-practice partnership. DESIGN: Nursing faculty from three Long Island, New York-based nursing programs within the partnership jointly created a qualitative focus group methodology to more fully understand the phenomena of interest. A set of open-ended interview questions guided the sessions. SAMPLE: Through purposive sampling, 42 undergraduate nursing students participated in 60-min focus group sessions. MEASUREMENT: Focus group data were transcribed. Content analysis, coding, and theme development was carried out collaboratively. The unit of analysis was the individual participant responses informed by group interaction. A researcher diary was maintained. RESULTS: One overarching theme and three sub-themes emerged from the data, reflecting student understandings in the areas of positioning, professional/personal identity, and social awareness. Ongoing analysis revealed patterns across the data sets linking student learning and the goals, milieu and workings of the partnership. CONCLUSIONS: Findings suggest that the context of a thriving community-based academic-practice partnership, established to improve population health outcomes, offered unique clinical learning opportunities for students through exposure to the values, ideas, and innovation of the partnership itself.