Challenges to EBP utilization and fidelity should be monitored as EBPs contribute to the delivery of high-quality care. Collaborations between universities and rural agencies may support an agency's abilities to adopt EBPs, train staff, and systematically assess impact.
Aim: The aim of this concept analysis was to examine stigma in the context of head lice, illuminating its components and providing insights for the development of appropriate nursing interventions.Background: Stigma associated with the phenomenon of head lice management is pervasive, promulgating fear and influencing policy and treatment practices. Few studies have examined stigma in this context.
Method:The method followed was the Rodgers's evolutionary method. Data Sources: Health, education, and social sciences databases were searched and yielded 20 articles spanning 1996-2018 used to create a relevant literature review. Results: Stigma arising from head lice infestation is preceded by an actual or perceived case of head lice, negative perceptions of lice, negative perception of groups or persons with head lice, or being associated with a group or person of lesser status believed to be a carrier of head lice. Defining attributes include marks of infestation, negative and unfair beliefs, and shame. Consequences of stigma are economic costs, social costs, mistreatment, and overtreatment with pediculicides. Conclusion: The concept of stigma in the context of head lice management is multifaceted. Further research is required to understand the magnitude of stigma as well as other factors associated with optimal treatment of children with head lice. K E Y W O R D S concept analysis, head lice, Pediculosis capitus, school and pediatric nursing, stigma AUTHOR BIOGRAPHIES
Background
American Indian (AI) and Alaska Native (AN) communities experience disproportionately high rates of tobacco use when compared to the overall U.S. population, especially among rural populations.
Methods
We implemented a single-blind, randomized clinical trial of a text messaging-based smoking cessation intervention through the tobacco quitlines of five states (Alaska, Minnesota, New Mexico, Oklahoma, and Wisconsin) with high percentages of AI residents. We partnered with state quitlines and Optum, a multi-state entity that manages quitlines. Participants who called the quitlines and identified as AI/AN were given the option to enroll in this trial. Upon consent, they were randomly assigned to either the standard quitline program (control) or a program culturally tailored for AI/ANs (intervention), which used a text messaging intervention to encourage smoking cessation. We adapted the text messages based on key informant and focus group input. Baseline data was analyzed for differences across age, sex, and the Fagerström Test for Nicotine Dependence.
Results
We recruited n = 487 AIs into the trial. Participants had an average age of 41.9 years (SD = 11.7) and 66% were female. The average Fagerström Test for Nicotine Dependence score was 5.38 (SD = 2.37). The intervention and control arms did not significantly differ across any of the baseline characteristics.
Conclusion
Implementation of this trial illustrated important lessons in adapting, implementing, and evaluating trials in collaboration with AI communities and local and national organizations. This work will inform future efforts to implement culturally-tailored interventions with AI/ANs and advance our knowledge about adapting and implementing smoking cessation interventions.
A B S T R A C TIntroduction: Cell phones and personal computers have become popular mechanisms for delivering and monitoring health information and education, including the delivery of tobacco cessation education and support. Tobacco smoking is prevalent among American Indians (AIs) and Alaska Natives (ANs), with 26% AI/AN adult men smoking compared to 19% of Caucasian adult males and 22% of African American adult males. Smoking is even more prevalent in Northern Plains AI populations, with 42% of men and women reporting current smoking. The literature on the availability and use of cell phones and computers, or the acceptability of use in health promotion among AIs and ANs, is scant. The authors report findings from a survey of AI students regarding their cell phone and computer access and use. The survey was conducted to inform the development and implementation of a text messaging smoking cessation intervention modeled on a program developed and used in Australia. Methods: A 22-item paper and pencil survey was administered to students at tribal colleges in rural Montana. The survey questions included cell phone ownership and access to service, use of cell phones and computers for health information, demographics, tobacco use habits, and interest in an intervention study. The study was reviewed and determined exempt by the institutional review boards at the tribal colleges and the lead research university. The study was conducted by researchers at the tribal colleges. Survey respondents received $10 when the survey was completed and returned. Data analysis was performed with the Statistical Package for the Social Sciences. Results: Among 153 AI respondents, the mean age was 29 years, range was 18-64 years. Overall, 40% reported smoking cigarettes with a mean age of 16 years at initiation. A total of 131 participants (86%) had cell phones and, of those, 122 (93%) had unlimited text messaging. A total of 104 (68%) had smart phones (with internet access), although 40% of those with smart phones reported that internet access on their phone was very slow or location limited. A total of 146 (95%) participants reported having access to a computer, although 32% of those did not have daily access. Students aged less than 23 years were more likely to have cell phones with internet access. Cell phone ownership differed by site (93% vs 77%, p=0.007). About 60% of the respondents who smoked indicated interest in participating in the intervention study.Conclusions: This study revealed that AI tribal college students in the rural communities surveyed had less cell phone, smart phone, and computer and internet access than that reported for undergraduate college students elsewhere in the USA. Research efforts and public health interventions must be culturally appropriate and technologically viable, therefore access to and acceptability of mobile technology must be evaluated when planning and implementing interventions for rural and other marginalized populations. The findings from this study contribute to the literature regard...
Mentoring programs have been used effectively with graduate and undergraduate nursing students and newly licensed nurses. There are few publications about mentoring for the RN enrolled in a bachelor of science in nursing (RN-to-BSN) program. To address low graduation rates in the public RN-to-BSN nursing programs, the Montana Center to Advance Health Through Nursing designed a mentoring program to help these nurses achieve their BSN. This voluntary program was initiated at an RN-to-BSN program in a 4-year college with six RN students who were paired with a mentor. An interactive, continuing education workshop on mentoring also was developed to prepare experienced nurses for their role as a mentor. This workshop was held nine times across Montana, with a total of 156 attendees. Workshop evaluations were consistently positive. Participants identified time and personality issues as barriers to successful mentoring and recommended expansion of the workshop to a distance-learning format so more nurses could attend. J Contin Educ Nurs. 2016;47(6):272-277.
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