Racism and Nursing Leadership in Massachusetts: A Mixed-Methods Study.

BACKGROUND: Nursing in the United States has evolved within the same historical context that has reproduced and spread racism worldwide. Nurse administrators are integral to the quality of nurses' practice and play a key role in eliminating racial injustice in places of work. PURPOSE: Using a feminist and critical race feminist framework, this study examined Massachusetts nurses' experiences of racism in their places of work, focusing on nurse administrators' influence on the nonadministrator (staff nurse) experience of racism experiences before and after George Floyd's death. METHODS: An investigator-developed, electronic survey was sent to Massachusetts professional nursing organizations for distribution to their members in 2021. Two hundred nineteen nurse respondents completed Likert-scale and open-ended branching logic survey questions to yield the quantitative and qualitative data analyzed for this mixed-methods study. FINDINGS: Nurse administrators were: 1) more likely than staff nurses to state that policies and meetings to address racism and diversity, equity, and inclusion had taken place before and after George Floyd's murder; and 2) less likely than staff nurses to directly experience racism at the hands of a colleague or a superior. Nurse administrators influence staff nurses' experiences of racism.

African American Nurses' Perspectives on a Leadership Development Program.

United States demographics are changing, but that change is yet to be recognized in the makeup of the nursing workforce. The underrepresentation of minorities in nursing is a longstanding problem, resulting in missed opportunities for culturally sensitive care that can foster optimal patient care outcomes. This report describes qualitative analysis of leadership opportunities emerging from a collaborative leadership development program between an urban baccalaureate nursing program and a large healthcare system in the northeast United States. The investigative team used qualitative methods to analyze the experiences of 19 participating African American (AA) RN graduates. Findings demonstrated that, for program participants, active engagement in personal and professional nursing leadership activities was enhanced. The academic-practice leadership program was an effective tool for enculturating AA nurses into the practice environment and into eventual leadership in nursing and healthcare.

African American Parent-Son Sexual Communication Among a College Sample.

UNLABELLED: To investigate whether reports of parent-child sexual communication (PCSC) varied by parental gender, education and living environments among African American adolescent and young male students attending a historically black university (n=146). DESIGN AND METHODS: Using secondary data a paired t-test was used to determine mean differences for PCSC by gender. Factorial ANOVA was calculated to examine the interaction between PCSC and living environment. RESULTS: Overall African American mothers were significantly more likely to engage in PCSC with their sons than African American fathers (t(68)=4.143, p<0.001). African American fathers from suburban areas were significantly more likely to engage in PCSC with their sons than urban fathers (t(137)=-2.295, p=0.023). No significant difference in PCSC by parental educational level was found. CONCLUSION: Findings from this research suggest that African American mothers continue to be the primary conversant in PCSC with their sons. Additional research is needed to understand the role that living environment (urban vs. suburban) plays in the father PCSC process. PRACTICE IMPLICATIONS: PCSC can play an important role in reducing adolescent sexual risk behaviors. Nurses should encourage and support PCSC among African American parents and their adolescent and young adult sons.

Students' Perspectives of Same-Day Clinical Assignments: A Qualitative Descriptive Study.

The clinical experience is essential to the nursing education process, but the process by which students are assigned patients has remained unchanged for decades. The purpose of this qualitative descriptive study was to determine the acceptability of a same-day clinical assignment process from the perspective of pre-licensure nursing students. Students' (n = 104) perceptions of the same-day clinical assignment process were collected via focus groups. Two themes emerged that may assist educators in implementing new methods for clinical assignments.

Confusion about HPV and Cervical Cancer Among Black/African-American Women Living with HIV.

Black/African-American women living with the human immunodeficiency virus (HIV) are at greater risk for developing cervical cancer. However, little is known about their understanding of the human papilloma virus (HPV), cervical cancer, or Pap testing. Therefore, the purpose of this paper was to examine HPV and cervical cancer among Black/African-American women living with HIV This is a secondary data analysis of a cross-sectional descriptive study aimed at assessing perception about cervical cancer and Pap testing among a convenience sample of 300 women living with HIV For this analysis, data from 211 Black/African-American female participants were extracted. The mean HPV and cervical cancer knowledge score was 6.12 out of a possible 15. Of the 211 participants, 6 answered all questions incorrectly. Less than half of the participants were aware that HPV is associated with cervical cancer, is classified as a sexually transmitted infedtion, or causes genital warts. The knowledge gained from this research can assist nurses and other health-care providers with the development of educational interventions that improve African-American women's knowledge of HPV, cervical cancer, and Pap testing.

Urban Lit and Sexual Risk Behavior: A Survey of African-American Adolescent Girls.

Adolescents spend an inordinate amount of time engaged with media, which is highly sexualized. Sexualized material can be found in music, on television and the Internet, as well as in magazines and books. Adolescents engaged with media are often influenced by this sexualized content, leading them to engage in risky sexual behavior. Urban literature (urban lit) is extremely popular among African-American female adolescents due to its portrayal of urban life and hip-hop culture. The purpose of this survey was to ascertain the extent to which African-American adolescent females are reading urban literature and to document whether this genre of literature had an effect on their sexual risk behaviors.

Understanding the Psychological Risks to Maternal Mental Health, Maternal-Infant Bonding, and Infant Development During the COVID-19 Pandemic.

This short review summarizes two recent U.S.-based studies in which researchers evaluated the impact of the COVID-19 pandemic on postpartum outcomes. The first study examined the neurodevelopmental status of infants born to women infected with SARS-CoV-2, and the second examined psychological risks to maternal-infant bonding. Results indicated that pandemic-related stressors likely contributed to diminished maternal-infant health outcomes. It is imperative that nurses stay informed on the latest science exploring the impact the pandemic has had on the health and well-being of pregnant persons and infants.

Parental influences of sexual risk among urban African American adolescent males.

PURPOSE: This study examined the influence of parental marital status, parent-child sexual communication, parent-child closeness on the HIV-related knowledge, safer-sex intentions, and behaviors of late adolescent urban African American males. DESIGN: The study employed a cross-sectional design with retrospective recall of salient parental influences and behaviors. METHODS: Data were collected via paper-and-pencil questionnaire from 134 late adolescent African American males, 18 to 22 years of age, recruited from urban communities in and around Boston, Massachusetts. Data were analyzed using bivariate correlations, paired t tests, and regression modeling. FINDINGS: Young men reported greater amounts of sexual communication with mothers than fathers (p < .001). Parent-child closeness was positively correlated with amount of parent-child sexual communication with both mothers and fathers (p < .001 for both). Parent-child closeness was, in turn, associated with greater condom use self-efficacy (p < .01), less permissive sexual attitudes (p < .001), fewer sexual partners (p < .01), and less unprotected sex (p < .01). Greater amounts of parent-child sexual communication were associated with fewer sexual risk behaviors, more consistent condom use, and greater intentions to use condoms in the future. There was evidence that parental influences on sexual risk behaviors and condom use intentions were mediated through young men's condom use self-efficacy, attitudes, and beliefs. CONCLUSIONS: These findings highlight the importance of the parent-child relationship and the role of parent-child communication between parents and sons. Further studies are needed to better understand the nature of father-son communication and develop strategies to help parents communicate effectively with sons. CLINICAL RELEVANCE: Evidence has shown that African American adolescent males are more likely to engage in high-risk sexual behaviors. Understanding the sexual risk communication between African American adolescent males and their parents is important to developing strategies in reducing sexual risk behavior.

Breast Cancer Risk, Coffee Consumption, and Postdiagnosis Survival.

This short review summarizes two studies that explore the association between coffee consumption, breast cancer, and mortality. The researchers found possible protective effects of coffee consumption and no association between coffee and increased risk of breast cancer. Nurses can help women who consume coffee to understand the current research regarding the relationship between coffee consumption, breast cancer risk, and mortality. Nurses can recommend referral to registered dietitians for comprehensive counseling on diet and cancer. Nurses can collaborate with interdisciplinary teams to help facilitate research regarding the association between coffee and breast cancer.

The influence of urban literature on African-American adolescent girls' sexual behaviors.

Many African-American teenaged girls are reading urban literature. This genre of literature is known for its gritty portrayal of urban life and has themes of violence, promiscuity, substance abuse and misogyny. Although research has demonstrated that the portrayal of sex and violence in the media are influential on adolescent sexual behavior, to date there has been little research on the influence of "urban lit" on adolescent sexual risk behaviors. This qualitative study explores the influence of urban literature on the sexual risk behaviors among a group of African-American adolescent girls. Findings from this study suggest that African-American adolescent girls may be influenced by the sexual themes depicted in this genre of literature. Additional research is needed to gain a greater understanding of this phenomon.

Examining Sleep Disturbance During the Menopausal Period.

Poor sleep is frequently reported by women during the menopausal transition period. Difficulties with sleep can affect women's physical and emotional health as well as their overall quality of life. Investigators have found that there is a correlation between a woman's menopausal history and poor sleep; however, there are differences within each menopausal stage. In this short review, we examine a recent secondary analysis study of quality of sleep and risk factors for poor sleep among women ages 45 to 54 years.

Father 2 Son: The Impact of African American Father-Son Sexual Communication on African American Adolescent Sons' Sexual Behaviors.

Parent-child sexual communication has been associated with reducing adolescent sexual risk behaviors. Limited research on parent-child sexual communication has been conducted on African American (AA) adolescent males who are at increased risk of sexually transmitted infections (STIs) including HIV/AIDS. The purpose of this research was to examine AA father-son sexual communication and the effect of contextual factors on the sexual risk behaviors. The final sample consisted of 96 AA adolescent males, ages 16-21 years. Structural equation modeling was used to examine the variables of interest (neighborhood characteristics, father-son closeness and connectedness, father-son communication, sexual permissiveness, condom attitudes, sexual risk behaviors). A path model was developed and tested. Results demonstrated that AA father-son closeness and connectedness were related to father-son communication. AA father-son communication was negatively related to sons' permissiveness and positively related to condom attitudes. Sons' permissiveness positively predicted their sexual risk behaviors. AA sons' condom attitudes did not negatively or positively predict their sexual risk behaviors. The findings from this study demonstrate that AA father-son communication is an important factor in decreasing AA adolescent males' sexual risk behaviors and HIV risk.

The latest advances in hormonal contraception.

Millions of women each year start or continue to use some type of hormonal contraceptive method. Choosing a method may be anxiety provoking. In this article, we review some of the latest advances in and options for hormonal contraception, including extended-dose oral contraceptives, the vaginal ring, injectable methods, and emergency contraception. Nurses can facilitate women's decision making for healthy reproductive options.

Recombinant Zoster Vaccine (Shingrix) to Prevent Herpes Zoster.

Women ages 50 years and older are at risk for herpes zoster, a reactivated virus from varicella zoster virus (chickenpox) that causes a painful vesicular rash and can result in postherpetic neuralgia. It is estimated that one in three adults will be affected by herpes zoster in their lifetime. Research evidence points to the need to prevent herpes zoster through vaccination. Since 2006, clinicians have been vaccinating adults with zoster vaccine live (brand name Zostavax), but the efficacy of this vaccine wanes with time and advanced age. In October 2017, the U.S. Food and Drug Administration approved recombinant zoster vaccine under the brand name Shingrix to prevent herpes zoster. Studies have shown significantly better efficacy of Shingrix versus Zostavax. This article summarizes new guidance regarding vaccination with Shingrix and discusses implications for women's health.

Sexual Misconduct Policies at Institutes of Higher Education: An Integrative Review.

Although federal legislation designed to advance sexual misconduct policies at institutes of higher education (IHEs) has been in effect for decades, recent national attention has put more pressure on IHEs to combat sexual violence on their campuses. Thus, the past few years have yielded significant research that examines federal compliance, dissemination, and perception of IHE sexual misconduct policies. This integrative review was conducted to assess sexual misconduct policies in the United States and the potential to prevent and combat sexual violence at IHEs through these policies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and using a quality assessment tool to ensure rigor, eight studies were synthesized. Findings indicate that IHE sexual misconduct policies vary widely and that most IHEs lack transparent, legislation-compliant policies. There remains a need for research examining the association between sexual misconduct policy, campus climate, and students' behavior, so as to better inform future sexual misconduct interventions and IHE policies. Forensic nurses may be key stakeholders in policy development that is currently missing from the literature.

Barriers to and Facilitators of Perinatal Depression Screening.

Depression is a significant health issue for women of reproductive age. A number of professional organizations have issued guidance regarding perinatal depression screening. However, some health care providers are reluctant to screen women. This column takes a second look at two recent research studies in which investigators examined the barriers to and facilitators of perinatal depression screening.

PrEP awareness and decision-making for Latino MSM in San Antonio, Texas.

Pre-Exposure Prophylaxis (PrEP) has been promoted among high-risk populations as an effective HIV biomedical intervention. However, limited research is available on the significance of culturally informed biomedical interventions for Latino MSM. A total of 159 self-administered Internet surveys were completed by Latino MSM ages 21-30 in San Antonio, Texas. The purpose of this research was to develop an instrument that measured Latino MSM attitudes and beliefs towards PrEP, identify associations between demographic factors and PrEP related factors and to suggest culturally appropriate strategies for the promotion of PrEP among the Latino MSM population. Research findings revealed implications for PrEP at the structural and individual level for Latino MSM. Structural level indicators emphasized the importance for raising PrEP awareness among Latino MSM in regards to PrEP related expenses, ameliorating stigmatization of high-risk populations, enhancing access to PrEP informed medical providers, and address mistrust of the government and medical providers role on addressing health disparities among Latino MSM. Overall, the findings for individual factors emphasize the need for patient-centered interventions for Latino MSM. Latino MSM currently on PrEP require supplemental resources to enhance PrEP adherence. Latino MSM not on PrEP require alternate options for PrEP delivery and/or cognitive behavioral approaches minimizing HIV risk behavior for Latino MSM concerned with PrEP toxicity, which may require non-biomedical interventions. Integration of Latino MSM currently on PrEP as peer educators provides a valuable resource for developing culturally informed PrEP interventions for Latino MSM. Peer educators are able to share their experiential knowledge of PrEP contextualized through cultural norms, beliefs, and values.

Assessing Marijuana Use During Pregnancy.

Recreational and medicinal marijuana uses have become more prevalent in recent years. Women's health nurses are increasingly likely to encounter pregnant women who use or have used marijuana. Research has found that inadequate screening for substance use, inadequate knowledge about the effects of marijuana use, and punitive counseling are barriers to women's understanding of the importance of seeking treatment for substance use. Provision of evidence-based counseling, education, and resources support women and strengthen the patient-provider relationship. Women's health nurses can gain a basic understanding of the effects of perinatal marijuana use and create a plan for women who have positive screening results. This article reviews two recent studies that examine marijuana use during pregnancy and suggest interventions that women's health nurses can implement.

Parent-Adolescent Sexual Communication.

Risky sexual behavior among adolescents is a major public health concern with potentially long-lasting consequences, including pregnancy, sexually transmitted infections, and HIV/AIDS. Researchers have demonstrated that parent-adolescent sexual communication can mitigate adolescent risky sexual behaviors; the development of interventions that support this process are vital. This column examines a recent study that evaluated a parent-adolescent sexual communication intervention.

Cervical Cancer Screening for Women Living with HIV.

Studies suggest that women living with HIV are not being adequately screened for cervical cancer. In this article we review the latest recommendations for cervical cancer screening in women with HIV and make recommendations for clinical practice.