Browsing by Sigma Chapters "Alpha Lambda"
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- ItemActive learning strategies for course enhancement: Monitoring adverse event reporting in Twitter(2017-06-21) Thorlton, Janet; Alpha Lambda
The purpose of this pre-test/post-test experimental study was to evaluate the impact of active learning strategies designed to appeal to six student learning styles: competitive, collaborative, avoidant, participant, dependent, and independent.
- ItemAdapting a vaccine administration process for COVID-19 in a federally qualified health centerDurham, Marianne L.; Gingell, Monica Joan; Johnson, Kaitlin E.; University of Illinois Chicago, Chicago, Illinois, USA; Alpha Lambda
As COVID-19 vaccines were being developed, the project team used quality improvement tools such as FMEA and process mapping to create a new COVID-19 Standard Operating Procedure at a Federally Qualified Health Center. Session will discuss successes and barriers to implementation in the ambulatory setting.
- ItemAddressing compassion fatigue of a family caregiver of adolescents in a mental health setting: A practice change projectMcWilliams, Suzanne; Wederski, Lonnie; Northern Arizona University, Flagstaff, Arizona, USA; Alpha LambdaFamily members who care for adolescents with a mental health disorder (AMHD) have yet to be recognized as an at-risk population for developing Compassion Fatigue (CF). The project introduced the concept of CF and the development of a program for family caregivers of AMHD at New Haven, a residential treatment center (RTC) for adolescent girls with mental health disorders. Staff therapists, nurses, educators, and support staff attended an educational program on CF, validated screening tools, interventions, and educational materials for family caregivers. A pre/post-Continuing Professional Development Reaction Questionnaire (CPDRQ) was used to measure their intention to change practice. Family caregivers attended a one-hour group session led by a staff therapist and completed a Family Quality of Life (FQoL) survey a modified Professional Quality of Life Survey and received interventions of knowledge, coping strategies, peer support programs, self-help, guided self-help. Predictive validity was estimated by comparing the pre-post scores of the CPDRQ. Overall, there was an increase in scores for all constructs with the most significant for the construct of intention and beliefs about capabilities. The results of the FQoL survey found a moderate level of burnout and secondary traumatic stress, which are indicators of CF. Follow up survey, 60.5 % who received the information on CF reported considering implementation or implemented an intervention. 50% reported sharing information with someone they trusted, 37 % reported making sleep a priority, eating a healthy diet, and learn to relax and meditate. The CPDRQ indicates the staffs' intention to change their practice suggested by the change in intention and beliefs about capabilities response. The results of the FQoL survey suggest that family caregivers are at risk for CF. The families who participated and received information on CF gained a new understanding and considered or had implemented one or more of the interventions.
- ItemAdult daughters' relationships with their institutionalized mothersMatthiesen, Valerie; LeSage, Joan; Alpha Lambda; Gamma Phi
A qualitative research design using grounded theory methodology was used to study adult daughters' relationships during the transitional period following their mothers' institutionalization in a nursing home. The central question was: What characterized the relationship between adult daughters and their institutionalized mothers? A voluntary sample of 32 adult, white women, age (40-71), were interviewed during a six month period in a large Midwest metropolitan area. Their mothers, age (72-99), had been residents in nursing homes for three months to 14 years. In-depth interviews were used for data collection based on the theoretical perspective of symbolic interactionism. Using methods of qualitative analysis, two Basic Social Processes were named. "Becoming the Chosen Daughter" was a Basic Social Psychological Process that occurred for those daughters who took on the responsibility of their institutionalized mothers. A matrix of role delegation and acceptance was developed for clarification of this process. These daughters either accepted, resented, or assumed their roles. Families either delegated or didn't delegate the roles to the chosen daughters. Becoming the chosen daughters resulted in profound changes in their lives. Changes in structural dimensions included: (a) time, (b) holidays, (c) vacations, (d) careers, (e) finances, (f) living arrangements, and (g) health. The phenomenon of family social support, or lack of such support, was an important social dimension. Guilt over institutionalization of their mothers and grief over their losses were of psychological importance. The Basic Social Structural Process of "Redefining their Roles," delineated the reorganization process of daughters' role relationships with their mothers. The four stages of the process were, (a) pre-institutionalization, (b) post-immediate, (c) transitional, and (d) reorganizational. Three outcomes of role reorganization emerged: (a) role resolution, (b) role flux, and (c) role disorganization. Social-psychological and structural factors important to role reorganization were: (a) previous mother-daughter relationship, (b) philosophical/religious beliefs, (c) social support system, (d) emotional status, (e) attitude, (f) health, (g) finances, (h) career, and (i) mother's length of institutionalization. Adult daughters reorganized their role relationships with their institutionalized mothers with the creation of new social worlds for themselves. Propositions were constructed which supported substantive role transitional theory for mother-daughter relationships in later life.
- ItemAggression in South Korean middle school students(2014-11-17) Choi, Jihea; Alpha Lambda
Purpose: Aggressiveness is a behavioral and emotional response made on purpose for the sake of destroying or damaging other persons or things (Kim & Kim, 2007). Currently South Korean society suffers from violent and inhuman juvenile crimes like collective bullying and school violence that are due to aggressiveness (Hwang, 2010). Juvenile violence due to aggressiveness in South Korean society is not just a current issue. Seven out of 10 cases of juvenile violence occurring between 2008 and 2010 were committed by middle school students, and 69% of school violence cases occurred in middle schools (Bae, Kim, Chung, Kang, & Park, 2010). Considering these data, more attention should be dedicated to studying aggressiveness in middle school students who are in early adolescence. Previous studies have attempted to clarify various factors that influence juvenile aggressiveness. Otherwise, concentrated re-investigation is necessary to reveal factors influencing Korean middle school students' aggression. In this study depression and academic stress as negative emotional aspects, and self-esteem, decision-making competency, happiness as positive emotional aspect of middle school students were investigated specifically. In conclusion, the purpose of this study was to assess levels of aggressiveness, and to determine factors affecting aggressiveness among South Korean middle school students.
Methods: A descriptive study was conducted using self-report questionnaires. The participants were 340 girls and boys from two middle schools and 302 questionnaires were used for the final data analysis. Aggressiveness was measured with the 'Aggression Questionnaire' developed by Buss & Perry (1992) and used in Shin's study (2000). It consists with 24 questions (5-point Likert scale) including physical aggression, verbal aggression, anger and hostility. Higher average scores correspond to higher levels of aggressiveness. Academic stress was measured with the 'Academic Stress Questionnaire' developed by Lee (2007), and it was developed to assess of middle school students' academic stress reflecting the educational environment of Korea. The measurement consisted with 25 items (5-point Likert scale) assessing perceived pressure from examinations, conflicts between family and friends related to academic performance and burden in relation to scores and class. Higher average scores correspond to higher levels of academic stress. Depression was measured with a 13-question checklist (5-point Likert scale) to evaluate depression, taken from the 'Symptom Checklist-90-Revision' revised by Kim, Kim, & Won (1984). Higher average scores indicate higher levels of depression. Scores above 70 percent of the measured score (above 3.5 out of 5.0) indicate that the person is depressed. Self-esteem was measured with the 'Self-esteem Scale' developed by Rogenberg (1965) and translated to Korean by Jeon (1974). It includes a 4-point Likert scale with a total of 10 questions to measure the levels of self-esteem and emotional aspects of self-approval. Higher average scores indicate higher levels of self-esteem. Decision-making competency was measured with the 'Decision-Making-Competency Inventory' developed by Miller and Byrnes (2001) and translated to Korean by Park et al. (2012). It includes a 5-point Likert scale with a total 18 questions to measure informed decisions, self-appraisal, autonomy, self-confidence. Higher average scores correspond with better decision-making abilities. Happiness was measured by the question 'do you think you are living happily now?' with a 5-point Likert scale. Higher scores indicated higher levels of happiness. Data were analyzed using descriptive statistics including t-test, one-way ANOVA, Pearson correlation coefficient and multiple regressions.
Results: Mean score for participants' aggressiveness was 2.49 out of 5. Academic stress was 3.38 out of 5, for self-esteem, 2.86 out of 4, for decision-making competency, 3.2 out of 5, and for happiness, 3.82 out of 5. Depression was 2.56 out of 5 that it was lower than 3.5 indicating depression. Significant explanatory variables for aggressiveness were grade, second grader (t = 4.39, p < .001), academic stress (t = 2.78, p = .006), and depression (t = 5.03, p < .001). The explanatory power of these factors was 26.9%, and it was statistically significant (F = 16.06, p < .001).
Conclusion: Findings indicate that depression, academic stress, and grade (second graders) influence aggressiveness. To decrease aggressive behavior, it is necessary to provide systematic and political programs in schools and local communities that can ameliorate negative emotional factors like depression and academic stress, especially for second grade middle school students. Additionally, development of positive factors such as self-esteem, decision-making skills, and happiness in middle school students is important to reduce aggressiveness.
- ItemApplication of the Theory of Planned Behavior to understand energy drink consumption behaviors in college students(2016-03-17) Thorlton, Janet; Purdue University, West Lafayette, Indiana, USA; Alpha Lambda
Session presented on Friday, July 24, 2015:
Purpose: College students consume energy beverages (i.e., energy drinks and energy shots) to fight fatigue, heighten concentration, and promote weight loss, raising conceRNabout adverse stimulant effects experienced with excess caffeine consumption. Since 2007, energy beverage-related emergency department visits increased 74% in those aged 18-25, some with instances of product misuse (e.g., mixing with alcohol and/or other drugs). The purpose of this formative study was to apply the Theory of Planned Behavior better understand behavioral intentions and predictors of energy beverage consumption in college students.
Methods: Using a mixed method study design, a convenience sample of college students attending a large MidwesteRNniversity completed an electronic survey that measured energy beverage consumption behaviors. The survey was comprised of questions designed to measure demographics, energy beverage consumption practices, medical history, sensation-seeking behavior, vitality (fatigue), and caffeine use. Two blocks of questions were developed to examine attitudes, subjective norms, and perceived behavioral control constructs related to energy beverage consumption. One open-ended survey question was asked: Describe reasons why you do or do not drink energy beverages. The quantitative data were analyzed in SPSS version 22.0 and included descriptive, correlational, and a multiple regression analysis to predict intent to consume energy beverages. The qualitative data were analyzed with QSR international NVivo 10 for Windows.
Results: The mean age of participants was 19 years (n=288). Of those, 90% reported having consumed energy beverages, with two-thirds reporting use for more than one year. The effects experienced as a result of consuming energy beverages were: trouble falling asleep (54%), heart racing (42%), and headaches (39%). More than half of the respondents reported consuming alcohol with energy beverages because 'it tastes good.' Eight themes emerged (alcohol mixer/party longer; tastes good; desirable stimulant effects; enhanced sports performance; unpleasant/unhealthy side effects; combat fatigue; enhanced focus; self-management for weight loss). The regression model explained approximately 75% of the variance in intent to consume energy beverages. After entry of attitudes, subjective norms, and perceived behavioral control, the total variance explained by the model was 74.8%, F(3, 279) = 276.05, p<.001. Attitude made the strongest unique contribution (beta = .79, p<.001) for explaining Intent to consume, followed by Subjective Norms (beta = .15, p<.001). Perceived Behavioral Control made the weakest contribution (beta = -.06, p<.05). The beta values for each independent variable made a statistically significant unique contribution to the dependent variable, intent to consume energy drinks.
Conclusion: Despite their popularity, the majority of respondents reported they believed energy beverages were unsafe, or were unsure as to their safety. Attitudes and social norms are key factors influencing intention and consumption of energy beverages in these college students. The Theory of Planned Behavior was useful as an organizing framework for this population, and future studies should be considered using larger samples from different populations. Findings from this study can be used to influence clinical practice, education, research, and health policy.
- ItemThe association of perceived stress to physical and affective health outcomes in sickle cell disease(2016-07-13) Ezenwa, Miriam O.; Alpha Lambda
Session presented on Monday, July 25, 2016:
Purpose: Pain is a major complication of sickle cell disease (SCD). Stress is known to trigger acute pain crisis or intensify chronic pain in patients with SCD.De, 2005, 1 Serjeant, 1994, 2. There is insufficient evidence about the effects of stress on fatigue, a ubiquitous symptom of SCD or on affective (anger, anxiety, and depression) symptoms in adults with SCD. Because SCD is marked by repeated ischemic attacks and chronic inflammation, which predisposes patients to the differential expressions of genes implicated in stress responses, Jison, 2004, 3, the SCD population is prime for understanding the relationship of stress with physical and affective health outcomes. Guided by the hypothalamic-pituitary-adrenal (HPA) axis theory, the purpose of this descriptive comparative study was to examine the relationship between perceived stress and physical (fatigue); and affective (anger, anxiety, and depression) symptoms in adult patients with SCD. The HPA axis theory states that the stress could induce stress responses and the release of neurotransmitters and hormones (e.g., cortisol, norepinephrine, and epinephrine) that can adversely affect health outcomes, and has been implicated as part of SCD symptomology. Wilkie, 2010, 4. We hypothesize that patients with SCD who report high perceived stress would be more likely to also report increased fatigue, anger, anxiety, and depression symptoms compared to patients with SCD who report low perceived stress.
Methods: Patients (N=54, mean age 36.3 +/- 10.9 years [ranged from 22-74 years], 96% African-American, 57% female) who were recruited between March 2015-December 2015 completed a demographic questionnaire, the Perceived Stress Questionnaire, and the PROMIS measures (anger, anxiety, and depression). Data were analyzed using the statistical software R. Results: We found the mean scores for the study variables to be: perceived stress (0.37-0.18); fatigue (56.5-9.4); anger (51.1-12.4); anxiety (52.9-9.1); and depression (51.6-10.0). As reported in the Table, our comparative analysis results showed statistically significant differences between Low Perceived Stress (PSI<=0.35, n=27) and High Perceived Stress (PSI>0.35, n=27) groups on fatigue, anger, anxiety, and depression. Conclusions: Findings provide preliminary evidence of the relationship between perceived stress; and fatigue, anger, anxiety, and depression in patients with SCD. Findings support the HPA axis theory and indicate that stress is associated with negative health outcomes in patients with SCD.
Results from future studies will confirm current findings and provide extra evidence to decipher the influence of perceived stress on physical and affective symptoms in patients with SCD. This evidence would be pertinent for informing future cognitive-behavioral intervention studies to decrease fatigue, anger, anxiety, and depression in patients with SCD who report stress.
- ItemAttitudes of Gratitude: Innovative Strategies in Improving Health and Wellness(2016-03-21) Weinstein, Sharon M.; Alpha LambdaSession presented on Monday, November 9, 2015: Your attitude plays a large role in determining whether you can feel grateful in spite of life's challenges. According to gratitude researcherRobert Emmons, gratitude is just happiness that we recognize after-the-fact to have been caused by the kindness of others. Gratitude doesn't just make us happier; it is happiness in and of itself! According to Emmons, gratitude is defined by your attitude towards both the outside world and yourself. He suggests that those who are more aware of the positives in their lives tend to focus their attention outside of themselves. One of the most significant changes in today's healthcare system involves the workforce, where career opportunities abound and work roles are evolving. The ability to fully engage a current and growing workforce across systems is a challenge at all levels of the organization. Building a culture of gratitude in the workplace is not easy, but research tells us that an attitude of gratitude is a good health choice as well as a good management choice. Gratitude may actually be the key to happiness and can contribute to a healthier mind, body, and spirit. Gratitude is a nutrient for one's health, and it contributes to a happier, healthier work environment. The benefits of gratitude go beyond a sense of self-worth, self-efficacy, and trust between employees. By practicing gratitude, we are celebrating what brings us joy, directs our actions, and influences our outcomes. One of the many benefits to expressing gratitude consistently and freely is that it fosters an environment where people experience a greater sense of purpose. It is a innovative, visible demonstration of how we can all make a difference and the benefits are far-reaching. Practicing gratitude can increase work satisfaction and happiness in general, strengthen the immune system, lower blood pressure, relax the body, increase energy levels, facilitate healthy sleep, foster better interpersonal relationships and become an integral part of an employee health and wellness program. The simple act of acknowledging things to be grateful for can influence our thoughts, action and mood. As an organization, the ability to foster an attitude of gratitude across the system can have a significant impact on the work environment. The presenter will share the evidence base related to attitudes of gratitude and health outcomes. She will address innovations related to mindfulness, engagement, journaling and positivity through a gratitude exercise.
- ItemBehavioral intervention with maternal participatory guidance improves preterm infant outcomes(2017-07-25) White-Traut, Rosemary C.; University of Illinois Chicago, Chicago, Illinois, USA; Alpha LambdaPurpose: This completed randomized controlled trial of 198 premature infants born at 29-34 weeks gestation and their mothers examined the impact of the H-HOPE (Hospital to Home: Optimizing the Preterm Infant’s Environment) intervention on infant behavior, infant feeding and growth during hospitalization, mother-infant interaction, and illness visits when the infants reached 6-weeks corrected age (CA). The research was guided by two models: Developmental Science and Adult Learning Theory.
Methods: Mother-infant dyads were randomly assigned to the H-HOPE intervention group or an Attention Control group. H-HOPE is an integrated intervention that included (1) twice-daily infant multisensory stimulation using the ATVV Intervention (auditory, tactile, visual, and vestibular-rocking stimulation) offered prior to feeding and (2) four maternal participatory guidance sessions by a nurse-community advocate team. Infant behavior was measured weekly during hospitalization via the proportion of alert states and the frequency of orally directed behaviors when infants were able to feed orally. Infant feeding was measured weekly during hospitalization by Medoff-Cooper’s nutritive sucking apparatus and growth was determined by daily weight gain and weekly length. Mother-infant interaction was assessed after hospital discharge at 6-weeks CA using Barnard’s Nursing Child Assessment Satellite Training–Feeding Scale (NCAST, 76 items) and Censullo’s Dyadic Mutuality Code (DMC, 6-item contingency scale during a 5-minute play session). Illness visits from hospital discharge through 6 weeks CA were reported by the mothers.
Results: There were no differences between the groups at baseline for any of the dependent variables. The infant behavior data showed that by day 7, the intervention group exhibited a significantly higher mean frequency of orally directed behaviors when compared with the Attention Control group (12.6 vs. 7.1 pre-intervention, p < 0.10; 51.8 vs. 33.2 during intervention, p < 0.10; and 8.9 vs. 5.3 immediately prior to feeding, p < 0.05). Also on day 7, the H-HOPE intervention group exhibited a significantly higher proportion of time spent in an alert state during intervention (0.26 vs. 0.11, p < 0.05) and immediately after intervention (0.28 vs. 0.06, p < 0.01).
Infant feeding during hospitalization differed between the two groups. A quadratic trend was observed for infant feeding as measured by the number of sucks, the number of sucks per sucking burst, and a sucking maturity index. The intervention group experienced an increasing significantly improved oral feeding by day 7 (Model estimates for group by day: number of sucks - β = 13.69, p < 0.01; number of sucks per sucking burst - β = 1.16, p < 0.01; and the sucking maturity index β = 0.12, p < 0.05). Sucking pressure increased linearly over time, with significant between-group differences reached at day 14 (β = 45.66, p < 0.01). During hospital stay, the H-HOPE group infants gained weight more rapidly over time when compared with infants in the control group (p = 0.04) and grew in length (p = 0.015) more rapidly than control infants, especially during the latter part of the hospital stay.
After hospital discharge and when the infants reached 6-weeks CA, NCAST and DMC scores for the Control and H-HOPE groups were compared using t-tests, chi-square tests and multivariable analysis. Compared with the Control group (n = 76), the H-HOPE group (n = 66) trended toward higher NCAST scores overall and higher maternal Social-Emotional Growth Fostering Subscale scores and had significantly higher scores for the overall infant subscale and the Infant Clarity of Cues Subscale (p < 0.05). H-HOPE group dyads were also more likely to have high responsiveness during play as measured by the DMC (67.6% versus 58.1% of controls). After adjustment for significant maternal and infant characteristics, H-HOPE group dyads had marginally higher scores during feeding on overall mother-infant interaction (β = 2.03, p = .06) and significantly higher scores on the infant subscale (β = 0.75, p = .05) when compared to controls. Infants assigned to the H-HOPE group were also half as likely to have illness episodes (illness visit to the clinic, emergency department (ED) or hospital readmission) as control infants (OR = 0.46, 95% CI = 0.22, 0.95).
Conclusion: Intervening with both mother and preterm infant during initial hospitalization and the first month following hospital discharge is a promising strategy to support infant behavior, oral feeding, and infant growth, improve mother-infant interaction, and reduce infant illnesses following hospital discharge.
- ItemBlood pressure and restorative sleep intensity are altered by chronic daytime sleep disruption in ratsMaki, Katherine A.; Mithani, Sara M.; Bronas, Ulf G.; Fink, Anne M.; University of Illinois Chicago, Chicago, Illinois, USA; Alpha Lambda
There is a serious need to develop preventative strategies reducing night-shift workers' risk of cardiovascular disease and stroke. I developed an animal model of disrupted sleep and found when rats had abnormal sleep patterns, overall sleep quality (quantified by delta power in the electroencephalogram) suffered and blood pressure increased significantly.
- ItemBuilding global nursing research capacity from efficacy to implementation in Malawi: Sustaining a 20-year collaborationNorr, Kathleen F.; Jere, Diana L.; Banda, Chimwemwe K.; Kumbani, Lily C.; Lofton, Saria C.; McCreary, Linda L.; Patil, Crystal L.; University of Illinois Chicago, Chicago, Illinois, USA; Alpha Lambda
This presentation describes a 20-year collaboration between two colleges of nursing in the USA and Malawi. We have had continuous research funding throughout. Our experiences in building research capacity and promoting collaborators' careers provide important lessons learned that can benefit others.
- ItemCreating a collaborative academic culture for successful scholarship in nursing faculty(2016-09-26) Kooken, Wendy C.; Hopkins, Amanda F.; Illinois Wesleyan University, Bloomington, Illinois, USA; Alpha Lambda
Session presented on Monday, September 19, 2016:
Pursuit of tenure is an arduous task. Expectations for tenure include achieving excellence in teaching, service, and scholarship. While different schools have varying requirements for tenure, one of the most difficult to achieve is scholarship. Scholarship at small, undergraduate schools of nursing is often a daunting task. At such institutions, teaching is often the primary focus and expectation, making completion of scholarship that much more difficult because of lack of time and resources. Many faculty, although PhD-prepared, find the transition to faculty responsibilities overwhelming and often take 5-15 years to develop a program of scholarship and master teaching (Heinrich & Oberleitner, 2012). Additionally, more tenure track faculty are being hired with master's degrees or doctorates of nursing practice, and in their education, research was not a foundation so they are unprepared for the rigors of scholarship to achieve tenure (Oermann, Lynn, & Agger, 2015). Therefore, academic environments, particularly at small universities are becoming increasingly complex, producing barriers for faculty to achieve success in scholarship. Although many institutions have modified versions of what is expected for tenure, scholarship at some level remains a valued obligation. In smaller academic settings, each faculty member may have diverse areas of research, leading to a lack of collaborative possibilities and contributing to feelings of isolation. Faculty are busy, especially in schools of nursing, with clinical courses at a variety of sites. There is little time to spend with other faculty members brainstorming and developing well-rounded relationships, particularly ones that enhance other's scholarship obligations and promote collaboration on scholarship with one another. Peer mentoring and blending various faculty members' strengths can help faculty members realize success by setting realistic goals, promoting accountability, perhaps improving faculty recruitment and retention (Heinrich & Oberleitner, 2012), and reducing incidences of incivility (Bostian Peters, 2014). The purpose of this presentation is to describe a 2 year, monthly, 1-hour faculty gathering (Think Tank) in which faculty share their scholarly pursuits, resources, research strengths, and experiences. Results of the Think Tank project indicate successful outcomes in producing scholarly accomplishments. Compared to scholarly achievements before Think Tank, collaborative projects among faculty increased. Publications and peer-reviewed national and international presentations saw significant growth. Faculty applications for internal and external funding also expanded. Successful strategies to engage faculty are described and successful outcomes are highlighted.
- ItemDevelopment and pilot testing of a social media-based educational sexual health intervention(2016-03-17) Lee, Monica; Jones, Krista L.; Bergren, Martha Dewey; Bojan, Kelly; Alpha Lambda
Session presented on Saturday, July 25, 2015:
The purpose of this project was to develop and determine the impact of a social media educational intervention on sexual health among 18-24 year olds residing in a Midwestern metropolitan city, as compared to self-exploration of educational resources delivered via a website. This evidence-based pilot project utilized pre- and post-test data for outcome measures. Forty-six participants were recruited, 23 randomized to 'like' a Facebook fan page (intervention) and 23 directed to view a website (control) containing links to educational material regarding sexually transmitted infections/human immunodeficiency virus (STI/HIV). The website did not change throughout the study, while educational information was posted to Facebook three times a week for six weeks. Pre-test data indicate ninety-one percent of participants reported sexual activity; 30% reported 6+ lifetime partners; however, 54% reported one partner in the last three months. Thirty-seven percent reported using a condom at last intercourse; and 44% were previously diagnosed with an STI. The low participation rate among post-test surveys provides limited data. These data indicate no difference between groups in sexual health education or behavior measures, such as condom use. There was a positive change in confidence with STI/HIV knowledge in both groups and an immediate sexual behavior change in condom use in the website group. The increased confidence of STI/HIV knowledge in the Facebook intervention group and website control group is promising in that Facebook and websites have the potential to disseminate educational material among adolescents and young adults. Low participation rates may be related to decreased presence of youth on Facebook and inability to engage participants directly, thus alternative social media applications should be explored. Future recommendations include conducting focus groups to determine preferred learning modalities, suggestions for engagement, recommendations for incentives, and exploration of alternative SNS for sexual health education dissemination.
- ItemDevelopment of a postpartum preeclampsia video to promote patient educationKendrick, Aisha; Gonzalez, Monica; Snethen, Julia; University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA; Alpha Lambda
Women's postpartum health has had increasingly poor outcomes. Antepartum and intrapartum care has continued to be a focus of improve yet postpartum follow up care continues be an area for improvement. The aims of this project focus on increasing provider knowledge and increasing the public awareness of postpartum health.
- ItemDevelopment of an instrument to measure quality of nurses' worklifeBrooks, Beth A.; Reichelt, Paul A.; Alpha Lambda
This study reports the development process and factor structure of a questionnaire to measure quality of nursing work life for registered nurses in hospital settings. Included is information on item generation, content validation, initial pilot testing, and results from the full study. The instrument was administered to registered nurses in Illinois. Confirmatory factor analysis using maximum likelihood estimation was used to examine the fit of the data with the hypothesized measurement model. Two rival models were also tested. Chi-square (X2 (819) = 3,220.70, p < .0001), goodness-of-fit indices (CFI = .48, GFI = .63, AGFI = .60), and parsimony ratios (GFI = .60, NFI = .39) were analyzed for the hypothesized four factor model. The chi-square analysis, fit indices, and parsimony ratios indicated another model would be a better fit. A revised four factor model was estimated based on Lagrange multiplier tests and theoretical considerations. Chi-square (X2 (819) = 3,050.23, p < .0001), goodness-of-fit indices (CFI = .52, GFI = .67, AGFI = .64), and parsimony ratios improved slightly (GFI = .64, NFI = .43) for the revised model and parameter estimate t-tests for all but three items were significant at p ≤ .05. Internal consistency reliability for the final instrument sub-scales included an alpha coefficient of .56 for the 4 item Work life/Home life Scale, (n = 265), .58 for the 11 item Work Design Scale, (n = 265), .88 for the 21 item Work Context Scale, (n = 265), and .49 for the 6 item Work World Scale (n = 265). An exploratory factor analysis revealed a two factor solution, but the two factors made little conceptual sense and were not amenable to being named. Evaluation and recommendations regarding the questionnaire are included.
- ItemDimensions of racial identity as predictors of physical activity in midlife African American womenHardy, Elaine Clarista; Corte, Colleen; Alpha Lambda; Mu Omega; Xi Pi
Physical inactivity leads to serious health consequences, particularly for midlife African American (AA) women. Midlife African American (AA) women are less physically active and have higher obesity-related morbidity and mortality than midlife White women. Studies to examine these disparities typically view AAs as a homogeneous group, despite evidence of important within-group variance. Using a culturally-adapted identity-based motivational model, the purpose of this study was to determine whether dimensions of racial identity have differential influence on physical activity in midlife AA women. A convenience sample of 252 AA women aged 40–65 was recruited from a predominantly Black community in Northwest Indiana. Using a cross-sectional design, participants completed the Jackson Heart Study physical activity measure (JPAC), and the Behavioral Risk Factor Surveillance Systems (BRFSS) physical activity measure along with a measure of dimensions of racial identity (Black American, Multicultural, Bicultural, Afrocentric, and Racial Salience), self-labeled race, and psychometrically valid and reliable self-report measures of known predictors of physical activity (self-efficacy, social support, neighborhood factors, BMI, and self-rated health). Using level of physical activity (JPAC) as the outcome variable, a multiple regression model was fit to the data. The mean age was 52+7 yrs, and 59% were obese (BMI>30). Multiple regression revealed the only dimension of racial identity that was predictive of level of physical activity was Black American (β=-.15) controlling for the other variables in the model. Black American racial identity was shown to negatively predict level of physical activity along with BMI (β=-.15), while, self-efficacy (β=.27), social support for physical activity (β=.17), and good/excellent health (β=.19) positively predicted level of physical activity, accounting for 24% of the variance in the level of physical activity. Using the BRFSS physical activity measure as the outcome variable, based on the distribution of the data, we collapsed these groups into two categories reflecting sufficient vs. insufficient activity .A logistic regression model was fit to the data. Logistic regression revealed the odds of engaging in sufficient levels of physical activity were 2.5 times higher for women who reported good or excellent health compared to those who reported poor or fair health. In addition, an increase of one point on the physical activity self-efficacy scale increased the odds of engaging in sufficient levels of physical activity by 20% while an increase in BMI one unit reduced the odds of engaging in sufficient levels of physical activity by 40%, controlling for other factors in the model. These variables significantly predicted sufficient physical activity. The disparities of race and sociocultural factors on health behavior have long been a focus of nursing. The findings from this cross-sectional study suggest that this sample of midlife African American women, having a strong dimension of racial identity in Black American, are more likely to engage in a lower level of physical activity. These findings provide foundational data necessary for future longitudinal work to examine the multidimensional role of racial identity on physical activity in midlife African American women over time. Longitudinal studies need to be developed with culturally, individually tailored interventions taking into account dimensions of racial identity to examine its effect on physical activity over time.
- ItemDistributive Justice and Social Policy: A Case StudySwider, Susan; McElmurry, Beverly; Alpha Lambda; Gamma PhiThis research focused on explicating the conceptions of just distribution of resources underlying one example of health policy. The policy used as a case study was federal funding of home health care under Medicare, during the period 1965-1984. The data consisted of the public records of debate on federal policy for home health care during this period. Based on an analysis of the concept of distributive justice, eight different criteria used to define the concept were operationalized: Ascription, Equality, "Justice as Fairness," Choice, Financial Need, Merit, Need, and Utilitarianism. Content analysis was performed on the data using these criteria, as well as several other policy-relevant variables. These variables included problem statement addressed in the debate, strategies suggested to address the problem, outcomes of the debate, type of debate, actors involved, and time period. Results indicated that the most frequently mentioned criteria for distributive justice were Ascription, Need, and Merit. Ascription was used often because the policy under discussion here was focused on one specific group, the elderly. Much of the debate categorized as Need-based focused on allocating resources to meet a variety of the needs of the elderly. Opposing arguments, often categorized as Merit-based, stressed that individuals have a responsibility to meet their own needs at whatever level they can afford. Discussions of the criterion of Need decreased towards the end of the period studied and were replaced by concerns with cost containment via cost shifting for services to the elderly themselves. No clear patterns were discerned between problems addressed, strategies suggested, and criteria of distributive justice, largely because the distributive justice arguments made were often expressed in global terms. Thus the same criterion of justice could be used to support opposing problem and strategy statements. These global arguments were common because of the difficulty of making specific justice statements in light of the reality of politics, where such statements increase the likelihood of alienating segments of the population. Inquiry into the role of morals in health and social policy serves to encourage dialogue on the value bases of social policy, resulting in more informed and thoughtful policy debate.
- ItemEffect of a drinker identity on smoking-related information processing and behavior(2016-10-14) Lee, Chia-Kuei; Alpha Lambda
Purpose: Drinking and smoking frequently co-occur in undergraduate students. A drinker identity − a valued identity related to alcohol consumption behaviors − predicts high levels of alcohol use and alcohol problems. Since alcohol use and tobacco use are often paired in the social context, smoking-related information, behaviors and routines may be encoded into a drinker identity. This study investigated the role of the drinker identity (drinker self-schema) on smoking-related information processing and behavior in undergraduate students who drink and smoke but do not self-identify as smokers. Also, the effects of early alcohol experiences with alcohol on the drinker self-schema were also explored.
Methods: This project included two phases, an online survey and an in-person session. The online survey was used to examine the self-schemas and the determinants of the drinker self-schema (parental alcohol problems, age of alcohol initiation, high school experiences of alcohol use and alcohol-related problems, friends’ alcohol use in high school, and socio-demographics). During the in-person session, information processing indicators (endorsements, response latency time, and recall) of smoking stimuli were measured using validated cognitive tasks. Finally, the Timeline Followback methodology was used to measure alcohol and tobacco use in the last 90 days.
Results: Based on the online survey study, a structural equation model showed that more parental alcohol problems predicted early alcohol initiation which in turn predicted more high school friends’ drinking. More high school friends’ drinking and early onset predicted higher drinking behaviors and more alcohol problems in high school. More alcohol problems in high school predicted the higher drinker self-schema score, which in turn, predicted higher frequency of alcohol and tobacco use in college. Results of the information processing tasks showed that higher drinker self-schema scores were associated with higher endorsements of positive smoking-related attributes and lower endorsements of negative smoking-related attributes. No significant associations were found for information processing indicators including response latency and recall.
Conclusions and Implications: Findings support the developmental model that early experiences with alcohol use lead to formation of a drinker self-schema which motivates alcohol and tobacco use. Results also partially support the cross-substance facilitation effects of the drinker self-schema on smoking-related information processing and smoking behavior. Interventions to delay early alcohol initiation or limit adolescent alcohol use and problems may prevent the development of a drinker self-schema. Interventions that target the drinker self-schema may reduce the levels of both alcohol and tobacco use.
- ItemEffectiveness of cultural competence educational intervention on patient and health professional outcomes: A systematic review(2017-07-27) Chae, Duckhee; Kim, Jin-Hee; Lee, Jin-A; Park, Seo-Jin; Chonnam National University, Gwangju, Korea, Republic of (South); Alpha Lambda
This study was to assess the effectiveness of cultural competence education for health professionals on patient and health professional outcomes; to identify an effective way to educate health professionals.
- ItemEffectiveness of group-visits in a women's lifestyle physical activity program for African-American women(2016-03-17) Wilbur, Jo Ellen; Miller, Arlene Michaels; Buchholz, Susan; Braun, Lynne T.; Dancy, Barbara; Rush University, Chicago, Illinois, USA; Alpha Lambda
Session presented on Friday, July 24, 2015:
Purpose: Theoretically-based group physical activity interventions have shown to be the most effective means of increasing physical activity in minority populations. Primary care providers, however, must refer patients to outside community resources where these group interventions have been developed and delivered. The group-visit or centering model, used in some primary care settings to provide health services and group interventions simultaneously, may offer a culturally-relevant, cost-effective alteRNive for delivering physical activity behavior change. In a large RCT, we examined the effects of a physical activity group-visit intervention with three different telephone support conditions (group-visit alone, group-visit + personal telephone calls, group-visit + automated outgoing telephone calls) on African American women's adherence to lifestyle physical activity. The purpose of this paper is, for all three study conditions, to: 1) describe the components of a group-visit physical activity intervention based on Social Cognitive Theory that emphasizes behavioral skills to adopt and maintain an active lifestyle, and 2) examine the effect of attendance at the group-visits (dose) on adherence to lifestyle physical activity.
Methods: The 12-month Women's Lifestyle Physical Activity Program was developed in collaboration with: a) African American women who attended one of seven focus groups conducted in their communities; b) African American women who participated in one of two follow-up focus groups after participating in a 12-month community-based physical activity intervention; and c) a community advisory board. The Women's Lifestyle Program had 6 African American nurse-led group-visits (lasting 2 hours, delivered every 5 weeks for the first six months, once during the last six months each) with two components: a facilitated group discussion and an individualized physical activity prescription. Women wore a pedometer/accelerometer, entered their steps weekly into an automated telephone response system, and based on an algorithm received feedback and a suggested step goal during the group-visit. Training of the interventionists, using a Group Leader Manual, consisted of a two-day program, monthly meetings with research staff, and yearly retraining. Six study sites (3 community hospitals and 3 community health care centers) were randomly assigned to six different sequences of the intervention conditions to counterbalance the effect of the order of administering the conditions. Eligibility criteria were: African American women, aged 40-65, without cardiovascular symptoms, and without disability related to walking.
Results: A total of 288 women (18 group-visit cohorts, 95/96 per condition) enrolled. Fifty-nine percent had hypertension and 15% diabetes. Retention was 94% at six months and 90% at 12 months. Over 80% of the women attended > five group-visits with no difference between study conditions. Satisfaction with group visits was high (M=5.93 on a 7 point scale) with no difference between study conditions. There was a significant relationship between group-visit dose and change in accelerometer steps at 24 weeks (r = .17, p = 0.01).
Conclusion: Overall retention and attendance at the group-visits were high. Attendance at the group-visit boosted change in physical activity. This may be an ideal format for patients with chronic health diseases because primary care providers can care for more than one patient in an appointment and patients can interact with others who share their problems.