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Background Although mobile health (mHealth) technologies are burgeoning in the research arena, there is a lack of mHealth interventions focused on improving self-management of individuals with cardiometabolic risk factors (CMRFs). Objective The purpose of this article was to critically and systematically review the efficacy of mHealth interventions for self-management of CMRF while evaluating quality, limitations, and issues with disparities using the technology acceptance model as a guiding framework. Methods PubMed, CINAHL, EMBASE, and Lilacs were searched to identify research articles published between January 2008 and November 2018. Articles were included if they were published in English, included adults, were conducted in the United States, and used mHealth to promote self-care or self-management of CMRFs. A total of 28 articles were included in this review. Results Studies incorporating mHealth have been linked to positive outcomes in self-management of diabetes, physical activity, diet, and weight loss. Most mHealth interventions included modalities such as text messaging, mobile applications, and wearable technologies. There was a lack of studies that are (1) in resource-poor settings, (2) theoretically driven, (3) community-engaged research, (4) measuring digital/health literacy, (5) measuring and evaluating engagement, (6) measuring outcomes related to disease self-management, and (7) focused on vulnerable populations, especially immigrants. Conclusion There is still a lack of mHealth interventions created specifically for immigrant populations, especially within the Latino community—the largest growing minority group in the United States. In an effort to meet this challenge, more culturally tailored mHealth interventions are needed.

There is a lack of quality evidence to guide nurses in the management of hypertension for this vulnerable population. Identification of barriers to effective treatment among this underserved population will assist nurses and other healthcare professionals in identifying best possible practices for patient care in clinical settings across Haiti.

Latinos in the United States are experiencing increasing incidences of uncontrolled high blood pressure (HBP). Health literacy is an important determinant of adequate HBP self-management, yet no community-based intervention has effectively addressed health literacy in the management of HBP in the target community. The purpose of this study was to test the acceptability and preliminary efficacy of a health literacy-focused HBP intervention in Spanish-speaking Latinos with uncontrolled HBP. Using a one-group pre- and post-test study design, the study intervention was delivered to Spanish-speaking Latinos in Baltimore, MD, who had uncontrolled HBP. The intervention consisted of four weekly group sessions for health literacy training combined with disease knowledge education in HBP management, followed by phone counseling and text messages for 3 months. Seventeen participants received the study intervention. Eleven who completed the follow-up assessment at 16 weeks reported high satisfaction with the intervention. Participation in the intervention resulted in improved blood pressure, numeracy, and psychological outcomes. Our findings support health literacy education as a promising avenue in promoting HBP control among inner-city Spanish-speaking Latinos. [ HLRP: Health Literacy Research and Practice . 2018;2(1):e21–e25.]

Background: Health literacy is a significant determinant of health behaviors, but the pathways through which health literacy influences health behaviors are not completely clear nor consistent. The purpose of this systematic review is to critically appraise studies that have empirically tested the potential pathways linking health literacy to health behavior. Methods: We performed searches of the electronic databases PubMed, Embase, and CINAHL to identify studies that proposed a conceptual framework and empirically tested the proposed mechanism through which health literacy influences certain health behaviors. Twenty eligible studies were included for analysis. Key Results: The 20 studies addressed various health behaviors: chronic disease self-management (n = 8), medication adherence (n = 2), overall health status (n = 4), oral care (n = 1), cancer screening (n = 1), shared decision-making (n = 1), health information sharing (n = 1), physical activity and eating behaviors (n = 1), and emergency department visits (n = 1). Most studies were conducted in the United States (n = 13) and used a cross-sectional design (n = 15). The Short Test of Functional Health Literacy in Adults was commonly used to assess health literacy levels. Selection of variables and their operationalization were informed by a theoretical model in 12 studies. Age, gender, race/ethnicity, and insurance status were reported antecedents to health literacy. The most commonly tested mediators were self-efficacy (n = 8) and disease knowledge (n = 4). Fit indices reported in the studies ranged from acceptable to excellent. Discussion: Current evidence supports self-efficacy as a mediator between health literacy and health behavior. Further research is needed to identify how health literacy interplays with known psychosocial factors to inform people's use of preventive care services. Future studies should include more disadvantaged populations such as immigrants with high disease burden and those with low health literacy. Theory-based, empirically tested health literacy models can serve as the conceptual basis for developing effective health interventions to improve health behaviors and ultimately decrease the burden of disease in such vulnerable populations. [HLRP: Health Literacy Research and Practice. 2020;4(1):e21-e44.] Plain Language Summary: This review systemically compiles, and critically appraises 20 existing studies that test conceptual frameworks that propose potential pathways through which health literacy affects health behaviors. The findings from this review can help inform the development of health literacy-focused interventions to improve the health behaviors of populations with disease burdens.

Background: With the rapid growth in online education programs in nursing, quality of education through this modality is becoming of greater importance. Purpose: This paper aims to explore current recommendations and standards for quality in online nursing education offered by nursing regulatory, accrediting, and licensing organizations. Method: Individual interviews were conducted with the leaders from four accrediting, licensing and certifying organizations in nursing about their perspectives on quality standards for online education. Findings: The following themes emerged from the qualitative interviews: Theme 1-Standards are not specific to online education; Theme 2-This is not up to us-Professional organizations can offer recommendations but not responsible for regulations; and Theme 3-Each institution has responsibility to provide support and evaluate the quality of online education. Discussion: Schools of nursing should continue to incorporate current standards for quality in online education as the methods of delivery continue to evolve in this highly technologically-oriented world.

Hidden figures of nursing: The historical contributions of Black nurses and a narrative for those who are unnamed, undocumented and underrepresented Unless I am allowed to tell the story of my life in my own way, I cannot tell it at all.

Aim and objective:To explore what is known about knowledge, attitudes and beliefs that influence hand hygiene practices in in low-and middle-income Caribbean and Latin American countries.Background: With the emergence of infectious diseases such as the recent COVID-19 pandemic, handwashing is key to preventing communicable diseases as they disproportionately affect populations in low-income countries. While hand hygiene is known to be the single most effective method for avoiding the transmission of infection, little is known about the beliefs and practices of individuals in these regions. Methods: Following PRISMA 2020 Checklist, an integrative review of studies published from 2008-2020 was conducted (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Whittemore and Knafl's method was used to review the literature. Six databases were searched, and the Johns Hopkins Evidence Based Rating Scale was used for study appraisal. Results: The review yielded 18 studies conducted across Latin America. Poor handwashing practices are influenced by various factors including inadequate education and training, cultural beliefs, lack of resources and substandard government regulations. Communicable diseases and other diarrheal illnesses were highly prevalent, especially after a major disease outbreak. Conclusion: Future post-disaster campaigns aimed at improving hand hygiene and handwashing practices should focus on beliefs and attitudes to affect behaviour change since there was a higher disease susceptibility during those times. Barriers to proper hand hygiene include false attitudes such as, washing hands only after touching bodily fluids/patient contact or not washing hands at all after open defecation.