bluuebunny/crossref_metadata_2025 huggingface dataset:
Applying Marketing Concepts to Promote Health in Vulnerable Groups
Authors: Fontana Susan A.
Published: May 2007

Public health nurses must have a valid marketing orientation. Two marketing concepts, exchange relationships and channels of distribution and their application for public health nursing practice, have relevance in this context. In spite of the complexities inherent in applying them, they can be used to promote health in at‐risk populations. By incorporating these concepts in planning and delivering public health nursing services, it is hoped that the health goals of a larger number of vulnerable individuals can be achieved.
Determinants of Home Care Nursing Hours for Technology‐Assisted Children
Authors: Leonard Barbara J. , Brust Janny Dwyer , Sielaff Bruce H.
Published: May 2007

In the 1980s home care, in contrast to hospital care, was reported substantially to reduce costs for third‐party payers who provided funding for technology‐assisted children. Savings were realized primarily because parents substituted for nurses, eliminating or reducing those costs. Third‐party payers' savings thus were directly related to the number of hours parents assumed care. Because home care relies on parents doing some of the work of nurses, decisions regarding nursing hours must consider family factors in addition to medical factors. We evaluated the number of nursing hours 31 Minnesota families with technology‐assisted children received, as well as the factors that determined the allotment of nursing hours. Most families (96.8%) received some hours of professional nursing care per day, and 16.1% received 24‐hour care. Multiple regression, however, showed that family factors, rather than the child's medical condition, influenced the number of hours, with married, lower‐income families with a younger child receiving the fewest.

Further discussion and study are recommended to understand more fully the impact family factors have on the allotment of nursing hours and home care costs.
Analysis of a Home Health Agency's Productivity System
Authors: Hellman Esther A.
Published: May 2007

Productivity is an important issue in home care. Employee perceptions of an equitable system are crucial and have been linked to job satisfaction, motivation, and production. Ten staff nurses, and all supervisors and program directors were interviewed to elicit perceptions of the productivity system. Staff nurses' time sheets for seven months were evaluated retrospectively for visit length, number of visits per day, payer source, mileage per day, and travel time per day. Mean time in minutes spent in the patient's home on intravenous visits (n = 58 visits) was approximately twice as long as that of home care visit (n= 11,573 visits). Mean length of hospice visits (n= 368 visits) was 25 to 29 minutes longer than that of mean home care visits. The proportion of Medicare reimbursement was negatively correlated with productivity bonus point achievement (when two high and two low bonus point outliers were removed). Recommended changes were based on both qualitative analysis of employee perceptions of the productivity system and quantitative analysis of time sheets.
De Madres a Madres: A Community Partnership for Health
Authors: Mahon Joan , McFarlane Judith , Golden Katherine
Published: May 2007

Abstract To increase the number of Hispanic women who begin early prenatal care, a community partnership for health was initiated among the general public, businesses, 14 volunteer mothers, and one community health nurse. Volunteer mothers living in the targeted community were taught how to identify Hispanic women at risk for not starting early prenatal care, and how to provide social support and community resource information within a culturally acceptable milieu. At the end of the first year of the partnership, over 2000 women at risk for not starting early prenatal care had been contacted by the volunteer mothers.
Baby's Milk: A Source of Trust Between Mothers and Nurses
Authors: Brodie Barbara
Published: May 2007

Abstract The task of providing infants adequate amounts of nutritious milk, in spite of mothers' ability to produce breast milk, has never been easy. In America cow's milk became the food of choice when mothers ceased to breast‐feed their infants. In the mid‐1800s advances in bacteriology and chemistry led to a beginning understanding of the role of microbes in food and the development of commercial proprietary formulas. Many mothers discontinued breast‐feeding at an early age and relied on these products for their children. With the growth of cities, dairy farms were pushed many miles from the consumers of milk. The distance the new uncooled milk had to be transported, especially during the hot summer months, increased the chances of milk‐borne diseases infecting infants. To combat the high rates of infant gastroenteritis and death, welfare reformers and health professionals banded together to improve the milk supply through pasteurization, certification, and safe distribution; and to educate the public, especially mothers, on ways to feed and keep their infants healthy. Through their close contact with mothers in their homes, nurses taught these women how to prepare, store, and feed infants’milk. When their babies survived the summer, mothers developed a sense of trust in the nurse and the things she taught about ways to protect their infants and the entire family's health.
Self‐Care and the Elderly: Review and Implications
Authors: Padula Cynthia A.
Published: May 2007

Abstract Self‐care is the most predominant and basic form of primary care, yet research in the area, particularly with respect to the elderly, has been minimal. As a result, despite the breadth of the self‐care movement, very little is precisely known and understood about it. Diminished functional health status is the major cause of loss of independence. Self‐care is conceptualized as an important strategy in maintaining functional health.
A Descriptive Study of the Attachment of Public Health Nurses to Family Physicians' Offices
Authors: Ciliska D. , Woodcox V. , Isaacs S.
Published: May 2007

Abstract Public health nurses (PHNs) have been attached to family doctors' offices as one mode of organizing the delivery of nursing services in the community. However, different nurses function in different roles on a continuum from gener‐alist to liaison. A descriptive study was undertaken to determine the most effective role for PHNs attached to family physicians' offices. Outcomes for both physicians and nurses were satisfaction with the role of the PHN, appropriateness of referrals, and accessibility for consultation. These outcomes were compared relative to the rating of PHNs of their role. A cohort of physicians without attachment PHNs were also surveyed to compare responses on the same criteria. The majority of nurses described their role generalist. This role was related to greater satisfaction for nurses and the physicians with whom they worked. Satisfaction with PHN service, ease of arranging consultation with PHN, and appropriateness of referrals from PHNs was greater for physicians who had the attachment than those who used the usual service.
Description of Learned Response to Chronic Illness: Depressed versus Nondepressed Self‐Help Class Participants
Authors: Braden Carrie Jo
Published: May 2007

Abstract The purpose of this study was to describe the effectiveness of a community‐based health‐promotion program that was collaboratively designed and that is currently being implemented by lay persons who have the diagnosis of systemic lupus erythematosus (SLE) and by health professionals. Two groups of SLE self‐help course participants contributed data for this theory‐guided preexperimental program impact study. Braden's self‐help model provided the theoretical framework. The variables addressed were severity of illness, limitations, uncertainty, enabling skill self‐efficacy, self‐worth, and life quality. The groups consisted of 35 subjects having low depression scores (≥ 77) and 37 with high depression scores (≤272) on a measure having a possible range of scores from 0 to 400. Data were collected at three points: at the beginning of class 1, after class 7 (7 wks later), and two months after completion of the course. A group (2) by time (3) by measures (10) MANOVA analysis procedure was used with a follow up univariate F test and Newman‐Keuls multiple comparison procedure. Significant change was evident for the level of depression group and for three interaction effects of group × time, group × measure, and group × time × measure.
Theoretical Components of STD Counselors' Messages to Promote Clients' Use of Condoms
Authors: Strader Marlene K. , Beaman Margaret L.
Published: May 2007

Abstract A survey of 34 counselors on sexually transmitted diseases from a large Midwestern state was conducted to compare their responses to promote condom use with clients' attitudes and normative beliefs regarding condoms. Four vignettes were developed using predictor variables about condom use based on the theory of reasoned action (TRA). Results indicate subjects responded minimally to TRA variables mentioned in the vignettes. Moralistic messages about condoms were the most frequent responses reported, followed by those on education, disease prevention, and fear. In some cases information provided was not relevant to behavior described in vignettes. Implications for health care professionals are that messages meant to change behaviors should reinforce clients' attitudes and normative influences, and moralistic or fear messages should be minimized.
Use of Formal Community Resources by Spouse Caregivers of Chronically Ill Adults
Authors: Winslow Betty , O'Brien Ruth
Published: May 2007

Abstract This descriptive correlational study examined the use of formal community resources of spouse caregivers of progressively chronically ill individuals. The convenience sample was 61 individuals with a definitive diagnosis of multiple sclerosis and their spouse caregivers. Results indicated that 34.4% of the sample used community resources. Relationships among caregiver demographics, extent of caregiving tasks, subjective burden, perceived uncertainty of the caregiver, functional incapacity of the chronically ill individual, level of social support, and the use of formal community resources were analyzed. Positively correlated (P < 0.05) with the criterion variable of use of formal community resources were the variables of caregiver age (rpb= 0.342), number of caregiving tasks (rpb= 0.424), caregiver employment level (X2= 8.25), and functional incapacity of the care receiver (rpb= 0.565). Results of discriminate function analysis indicated that three variables, functional incapacity, caregiver age, and number of caregiving tasks, correctly classified users versus nonusers of community resources 83.6% of the time.
Health Maintenance, Health Promotion: Is There a Difference?
Authors: Tripp Sally L. , Stachowiak Barbara
Published: May 2007

Abstract Nurses in community settings are seeing more health care consumers who are medically stable and who are asking for assistance in areas such as exercise, stress reduction, nutrition, and illness and accident prevention. These requests can be characterized as concerns of health maintenance or health promotion. Two nursing diagnoses, altered health maintenance and health‐seeking behaviors (specify), enable the practitioner to address these concerns in clinically useful ways. Through case studies and comparative tables, the differences between these two diagnoses is clarified to enable nurses to identify, treat, and evaluate efforts made to enhance health‐oriented behaviors.
Adaptation Themes for Prenatal Care Delivered by Public Health Nurses
Authors: Affonso Dyanne D. , Mayberry Linda J. , Graham Katherine , Shibuya June , Kunimoto June , Kuramoto Mae
Published: May 2007

Abstract An adaptation process involving three cognitive themes provides the framework for community nursing model for prenatal care on the island of Hawaii. The themes are based on the cognitive adaptation model developed by Taylor (1983) and include search for meaning, sense of mastery, and self‐esteem. Each theme is used to guide public health nurses and is identified during designated encounters between the nurse and woman throughout the duration of prenatal care. A focus on adaptation themes for each trimester of pregnancy expands on the medical model of prenatal care to highlight developmental processes of childbearing and broaden the scope of practice for public health nurses responsible for assessment and intervention in the community.
An Inner‐City Community's Perspective on Infant Mortality and Prenatal Care
Authors: Reis Janet , Mills‐Thomas Berneice , Robinson Denise , Anderson Virginia
Published: May 2007

Abstract Neither expanded Medicaid eligibility nor case‐finding approaches have significantly increased use of early prenatal care. Failure to improve use points to the importance of further study of the broader community's perspectives on prenatal care and perinatal health issues. A convenience sample of 380 low‐income, inner‐city, black adults were interviewed with respect to their understanding of infant mortality, perceived barriers to and importance of prenatal care, and recommended numbers of prenatal visits. All respondents reside in a community with negative indexes of perinatal health as measured by infant mortality, low birthweight, and average number of prenatal visits. Fifty percent of the sample could correctly define the term infant mortality. The majority believed that prenatal care is very important and should begin in the first trimester of pregnancy. Respondents recommending the least number of prenatal visits (0‐6) perceived financial, institutional, and attitudinal factors as barriers to care. Pregnant women's fear of detection of drug use was the most salient barrier regardless of the recommended number of prenatal visits, age. sex, employment status, or number of children. Changing health problems mandate continued monitoring of community perceptions and expectations of services such as prenatal care. Public health nursing is ideally positioned to articulate community values to policy makers and health care professionals concerned with perinatal health.
Women's Perspectives on Homelessness
Authors: Hodnicki Donna R. , Horner Sharon D. , Boyle Joyceen S.
Published: May 2007

Abstract An increase in the number of individuals who are homeless since the 1980s has made homelessness a major social, economic, and political problem in the United States. The number of homeless in this country is estimated as high as 3 million, with women and children constituting the fastest growing subgroup of this population. A study of eight homeless women using a shelter in a southeastern city was conducted to explore the experience of homelessness from the women's perspectives. A modified ethnographic approach using a semistructured interview provided qualitative data. The constant comparative method of analysis identified themes of heightened awareness, guarding, identification of needs, and strategies for resolution. This study provides a new understanding of how some women experience homelessness. as well as the responses they take to solve this problem.
AIDS Education on the College Campus: Roy's Adaptation Model Directs Inquiry
Authors: Vicenzi Angela E. , Thiel Robert
Published: May 2007

Abstract We assessed the beliefs of 49 college students regarding the acquired immunodoficiency syndrome (AIDS), condom use, and sexual behaviors related to AIDS prevention. Roy's modes of self‐concept, interdependence, and role function were used as a framework to find psychosocial determinants that influence safer sex practices. Interdependence was measured by a sexual regard scale. Beliefs regarding both AIDS beliefs and condom were very positive. Students were selectively using safer sex practices; most reported avoiding high‐risk partners, but only 39% were using condoms. No significant associations were found among the four independent measures of AIDS beliefs, condom beliefs, self‐esteem, and sexual regard or with the dependent measure. AIDS safer sex practices. A two‐hour safer sex educational module did change several beliefs but did not increase safer sex practices. Most participating students stated they had a good understanding of how AIDS was spread, they knew how to use condoms correctly, and they discussed AIDS with friends and parents.
Vision for the Future of Public Health Nursing: A Case for Primary Health Care
Authors: Beddome Gail , Clarke Heather F. , Whyte Nora B.
Published: May 2007

Abstract Canada has embraced the goal of the World Health Organization to achieve health for all. This has created a paradigm shift from a focus on direct care to include health promotion and community development, consistent with a primary health care approach. Nevertheless, a clearly articulated vision for the role of public health nurses (PHNs) is lacking. Despite the fact that PHNs make up the largest group of health care workers in the community, their collective opinions and ideas regarding their own practice are seldom sought in a systematic manner. We conducted a survey of public health nurses in British Columbia. Using a two‐wave Delphi approach, PHNs were asked to define issues for the future of public health nursing, and to state publicly their preferences for change and transformation. The responses were rank ordered, analyzed, and compared with recent nursing and health care literature to interpret their content. The PHNs' visions for tomorrow agree with concepts of primary health care and community development, and have implications for community health nursing's practice and education.
Job Satisfaction of Rural Public and Home Health Nurses
Authors: Juhl Nyla , Dunkin Jeri W. , Stratton Terry , Geller Jack , Ludtke Richard
Published: May 2007

Abstract Based on Vroom's expectancy theory, this study was conducted to identify differences in job satisfaction between nurses working in public health settings, and staff nurses and administrators working in both settings. Questionnaires containing an adaptation of a job satisfaction scale were mailed to all 258 registered nurses practicing in public health and home health settings (response rate 57%) in a rural midwestern state. Respondents were asked to rate their satisfaction with various dimensions of their jobs, as well as how important each aspect was to them. Although both groups of nurses reported low satisfaction with salary, public health nurses were significantly less satisfied with their salaries than were home health nurses (F = 32.96, P≤0.001); home health nurses, however, were significantly less satisfied with benefits/rewards (F = 11.85, P≤0.001), task requirements (F = 8.37, P≤0.05), and professional status (F = 5.30, P≤0.05). Although administrators did not differ significantly from staff nurses on job satisfaction, they did perceive organizational climate (F = 4.50, P≤0.05) to be an important feature of satisfaction. These differences may be partially explained by divergent salaries, roles, and responsibilities between public health and home health nurses.
Lifestyle Changes and Coping Patterns Among Caregivers of Stroke Survivors
Authors: Periard Mary E. , Ames Barbara D.
Published: May 2007

Abstract Although caregiving has been a major focus for research, little is known about the day‐to‐day changes in lifestyle faced by caregivers. Yet lifestyle, developed over time, manifests an individual's very identity. Using a multimethod approach, we assessed the perceptions of lifestyle changes and coping patterns of 20 caregivers of first‐time stroke survivors in the early poststroke period. An outcome‐oriented matrix was employed for qualitative analysis, and findings were expanded by additional quantitative analysis. Three themes emerged: pervasiveness of lifestyle change, cohort differences in the perception of lifestyle change and coping patterns, and primary issues of time and confinement. Findings suggest that strains relative to caregiving may not be confined to direct caregiving activities, but may be related to established patterns of daily life.
Meaning and Purpose in the Lives of Persons with AIDS
Authors: Coward Doris D.
Published: May 2007

Abstract Little research has been reported that explores meaning‐discovery and meaning‐making in persons with AIDS. Self‐transcendence experiences, as proposed by Reed (1991), may lead to maintenance or restoration of mental health in persons facing end‐of‐life issues. Nurses who work with persons with life‐threatening illness, such as men and women with AIDS, have opportunities to facilitate choices that lead to experiences from which meaning and emotional well‐being may be obtained. This study used a phenomenological approach to describe experiences of 10 men and 10 women with AIDS that led to feelings of increased self‐worth, purpose, and meaning in their lives. Participants provided oral or written descriptions of experiences associated with feelings of increased connectedness with others, sense of well‐being, and hope for longer life. Data were analyzed using Colaizzi's phenomenological technique (1978). Although men and women with AIDS faced some of the same issues, their responses were different. By incorporating gender and individual differences, nurses may be better able to create therapeutic exchanges in which self‐transcendence views and behaviors are fostered in both men and women with AIDS.
Influencing Community Leaders toward the Promotion of Prenatal Care at the Community Level
Authors: Kozlowski Lisa A. , Zotti Marianne E.
Published: May 2007

Abstract The threefold goal of this quasi‐experimental study was to have an impact on knowledge, beliefs and intentions of community leaders related to promoting prenatal care for low‐income women. Using a twenty‐one community leaders from a selected urban community in Wisconsin participated in an educational intervention that used a pre‐ and post‐test design. The primary goal of the intervention (based on change theory) was to increase community leaders' motivation and decrease their resistance to promoting prenatal care for low‐income women in their communities. Various media were used to illustrate and emphasize important prenatal concepts. Community leaders were also given information on the status of maternal and infant statistics and health practices in their communities. This intervention significantly increased community leaders' general knowledge related to prenatal issues; positive beliefs toward the promotion of prenatal care; and intent to engage in activities to promote prenatal care for low‐income women. This study reveals that community health nurses can function effectively as agents of change with community leaders.
The Impact of Home Visits on Enrollment Patterns in Pregnancy‐Related Services among Low‐Income Women
Authors: Bradley Patricia J. , Martin Joanne
Published: May 2007

Abstract Medicaid now reimburses for care‐coordination services for pregnant women in about half of the states. This care‐coordination project targeted low‐income pregnant women in two Indianapolis neighborhoods that historically have had high black‐infant mortality rates. The service provided home visits by teams of workers including registered nurses, social workers, and indigenous community health workers. This retrospective descriptive study evaluated the impact of the home visits on enrollment in pregnancy‐related services. Data were collected from the care‐coordination records of 381 participants who delivered infants between July 1,1990, and January 1,1992. The proportion of participants enrolled in prenatal care, the Special Supplemental Food Program for Women. Infants and Children (WIC), Medicaid, and Food Stamps increased significantly following admission to care coordination. The majority of participants who enrolled in prenatal care and WIC, after admission to care coordination, did so within one month of admission. Home visits were effective in stimulating enrollment in pregnancy‐related services. Further studies need to be done to evaluate the impact of home visits on pregnancy outcomes as well as their cost‐effectiveness.
Case‐management of AIDS Clients as a Predictor of Total Inpatient Hospital Days
Authors: Twyman Deanna M. , Libbus M. Kay
Published: May 2007

Abstract AIDS has shifted from an acute short‐term terminal illness to a progressive, chronic disorder. Evaluation of AIDS case‐management is imperative due to both the increasing numbers of cases and the lengthened survival of those with the disease. In 1988 the Missouri Department of Health (MDOH) initiated the first statewide system of AIDS case‐management in the United States. This study was done to determine if deceased AIDS clients who received MDOH case‐management services had fewer inpatient hospital days than clients who did not receive these services, during the last six months of life. Death certificates and Medicaid records were merged for 100 case‐managed and 99 control, non‐case‐managed AIDS clients. No significant difference between groups was found in number of inpatient hospital days. Further, neither age, ethnicity, gender, cause of death, nor specific AIDS risk factors were associated with total number of inpatient hospital days. The client‐centered philosophy of the program may have encouraged case managers to utilize all available service, including hospitalization, without considering cost‐containment issues. Future evaluation efforts will investigate both cost‐containment and quality‐of‐life indicators, such as satisfaction with care, of case‐managed AIDS clients.
Immunization Status of 2‐Year‐Olds in Middle/Upper‐ and Lower‐Income Populations: A Community Survey
Authors: Salsberry Pamela J. , Nickel Jennie T. , Mitch Roberta
Published: May 2007

Abstract Immunization rates of preschool children in the United States are well below recommended levels. Whereas low‐income and minority groups have been targeted as at risk for inadequate immunization, the assumption is generally made that middle/upper‐income children are adequately immunized through the private sector. We conducted a community‐based survey that refutes this assumption. Only 31% of the 302 parents surveyed reported full immunization of their 2‐year‐olds. No significant differences were found in the immunization rates for middle upper‐income (34% immunized) versus lower‐income children (28% immunized). Failure to receive the 18‐month doses of DTP and polio was the most frequent cause of inadequate coverage for both groups. Barriers to immunization reported by middle/upper‐ and lower‐income parents were similar, with over one‐third of the parents identifying cost and lack of insurance coverage as problems. Additional barriers related to methods of operations of providers. Findings have immediate implications for public health nurses in terms of assessing coverage of their own preschool populations and introducing corrective actions to improve levels of immunization.
Daily Stressors and Coping Responses: A Comparison of Rural and Suburban Children
Authors: Sorensen Elaine Shaw
Published: May 2007

Abstract Although research has examined problems of stress and health among rural families, little is known about coping phenomena directly from the perspective of rural children. This study compared two groups of children, one rural and the other suburban, in their reports of daily stressors and coping efforts as actually experienced. Using semistructured diaries over a period of six weeks, 21 rural children and 23 suburban children reported daily sources of stress, coping efforts, and coping resources. Rural children were more compliant in completing diaries. They reported more internal, cognitive‐intrapsychic source of stress, whereas suburban children listed more external environmental sources. Suburban boys reported submission as the most common coping response, and rural boys listed organized activities and problem‐solving approaches. Other interesting differences between the rural and suburban children, and gender differences among both groups emerged.
Mississippi Public Health Nurses and Midwives: A Partnership That Worked
Authors: Roberts Edna R. , Reeb Rene M.
Published: May 2007

Abstract At the turn of the century maternal and infant mortality rates were high in this southern state. Untrained midwives conducted many of the deliveries. Initial support for locating and training midwives by public health nurses was provided by the American Red Cross and the United States Public Health Services. Later, funding from a philanthropic organization (Rockefeller International Foundation) provided a mechanism that brought Mississippi public health nurses and midwives to a partnership that endured for over a half a century, and contributed to better maternal‐infant health care outcomes for that state.
A Public Health Nurse's Guide to Reading Meta‐Analysis Research Reports
Authors: Conn Vicki S. , Armer Jane M.
Published: May 2007

Abstract Meta‐analysis research reports are increasingly found in the public health literature. Meta‐analysis is a quantitative method for summarizing existing studies. Although it is often advocated to synthesize research, nurses must be able to read these reports critically to determine applicability to practice.
Cardiovascular Health Promotion in Children: Program and Policy Implications
Authors: Harrell Joanne S. , Frauman Annette C.
Published: May 2007

Abstract Cardiovascular disease is the leading cause of death in the United States; it is also a major factor in rising health care costs. Risk factors for the disease are present in childhood, at the time when lifelong health habits are forming. Thus, strategies for improving the cardiovascular health of children through programs and policy may be expected to have a maximum effect. The cardiovascular health in children study identified the prevalence of cardiovascular risk factors in 2209 children age 8 to 11 years, attending 21 rural and urban public schools in North Carolina. Schools were randomly selected from three regions of the state (coastal, piedmont, mountain) in which the frequency of cardiovascular disease differs. Initial results of the study demonstrate the use of such findings in formulating health policy and in designing intervention programs.
Public Health Nursing Research Priorities: A Collaborative Delphi Study
Authors: Misener Terry R. , Watkins Joyce G. , Ossege Julianne
Published: May 2007

Abstract
The purpose of this study was to identify research questions and priorities in public health nursing based on the perceived needs of practicing public health nurses, and to assess whether the respondents believed that the profession should provide leadership in the study of the identified questions. Using a modified Delphi survey. 76 research priorities were ranked and produced three factors or categories of questions during the two rounds: outcomes in maternal‐child and family planning, outcomes in home health services, and public health nurse recruitment, retention, job satisfaction, and image. Forty‐seven (62%) of the 76 priorities were deemed appropriate for nursing to assume leadership in seeking answers. Results reveal a consensus of research priorities generated by front‐line nurses consistent with year 2000 health objectives for the nation.
Obtaining Telephone Numbers for a Rural Medicaid Population: Issues for Outreach and Research
Authors: Donat Patricia L. N. , Selby‐Harrington Maija L. , Quade Dana , Brastauskas Brenda S.
Published: May 2007

Abstract This study examined the accuracy and costs of determining whether rural, low‐income Medicaid recipients did or did not have a phone, and of obtaining phone numbers for those who did. For a random sample of 209 families, we compared phone information obtained from phone books and directory assistance with information obtained from department of social services (DSS) records. DSS records identified 51% of the sample as having phones, compared with 19%‐25% for phone books and directory assistance. For identifying families as having no home phone or a phone with a number that matched the one in the DSS record, phone books or directory assistance corresponded with DSS records in 52%‐57% of the sample. Using phone books or directory assistance was up to 3.2 times more costly than using DSS records. The study highlighted the need to establish policies to promote the exchange of information between social services and public health agencies and researchers.
Cardiac Risk Evaluation for Elementary School Children
Authors: Purath Janet , Lansinger Theresa , Ragheb Carol
Published: May 2007

Abstract This study examined cardiac risk factors in school‐age children. Specific risk factors focused on were smoking, hypertension, elevated blood cholesterol, obesity, physical inactivity, and nutritional imbalances. All consenting students in grades one through five participated. Components of the study included screenings and a questionnaire. Children (N= 357) were screened for height/weight, resting pulse, blood pressure, cholesterol, skin‐fold thickness, and fitness. The questionnaire included an assessment of family diseases and family health practices. Results showed no significant relationships between cholesterol and family history of hypercholesterolemia or coronary heart disease, cholesterol and overweight, cholesterol and amount of time students exercised and the amount of time student's mothers exercised (r= ‐0.25, p= .0028), cholesterol elevation and exercise (r= ‐0.25, p‐value = 0.007), and exercise and the frequency of eating out in a restaurant (r= ‐0.18, p‐value = 0.03).
Community Empowerment in Rural Health Care
Authors: May Kathleen M. , Mendelson Cindy , Ferketich Sandra
Published: May 2007

Abstract The Healthy Communities 2000 mandate calls for public health leaders to involve community members in setting health priorities and implementing programs in response to the national health objectives for the year 2000 (American Public Health Association, 1991). This paper describes community involvement through a community empowerment nursing intervention and evaluates its application in a rural community. A community health nursing project (AHCPR, Grant No. HS06801) with three interventions, one of which was community empowerment, was designed to address the health needs of small, rural, underserved, primarily Mexican American communities in Arizona. Community empowerment in this project was based on the community‐development approach to community organization, and involved community health nurses and lay health workers, called promotoras, who are key persons in community development. The implementation of two health fairs, one the result of the community‐empowerment intervention, is described and evaluated in relation to community health. The community‐empowerment intervention was based on community participation and responsibility, hallmarks of the second health fair, reflecting lay expertise and cooperation among various levels of the community. Successes and limitations of the health fairs provide feedback for developing a community‐empowerment intervention.
The Howard Association of New Orleans—Precursor to District Nursing
Authors: Hanggi‐Myers Laura
Published: May 2007

Abstract Although philanthropist William Rathbone is generally recognized as the founder of district nursing (in Liverpool, England, in 1859), the Howard Association of New Orleans actually began to use a pattern of district nursing 26 years earlier as a response to yellow fever epidemics. Concepts brought forth by the association included dividing the city into districts; teaching preventive measures; using community members to locate those needing assistance; and caring for the sick in their homes, utilizing nurses when the need arose.
A Description of the Gender Differences in Risk Behaviors in Young Adults with Genital Herpes
Authors: Swanson Janice M. , Dibble Suzanne L. , Trocki Karen
Published: May 2007

Abstract The purpose of this paper is to describe gender differences in risk behaviors—substance use and sexual behavior—in young adults with genital herpes. Two‐hundred fifty‐two young adults with genital herpes were recruited into the study via newspaper advertisements in a West Coast metropolitan area. As a part of a large randomized clinical trial, participants completed questionnaires measuring demographic characteristics and the risk behaviors of substance use and sexual behavior. Participants had a mean age of 27.1 years and were largely Caucasian, employed, college‐educated, and heterosexual. Women were two years younger than men and had less income. Gender differences were found in both substance use and sexual behavior. Men were more likely to report current use of illicit drugs than were women. Men were also more likely to report a history of gonorrhea, and urethral discharge. Women reported initiating sex at an older age and having fewer sexual partners over their lifetimes than men. There were no gender differences in use of condoms or spermicides specifically to prevent transmission of genital herpes. Further study is needed of these young adults as they are at high risk for transmission of the disease and also for contracting other sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection. Sensitive interventions are needed with this high‐risk population.
The Prevalence of Leg Ulcers in Older People: Implications for Community Nursing
Authors: Johnson Maree
Published: May 2007

Abstract The prevalence of chronic leg ulcers has been investigated in older people living in the community. This condition has a low prevalence, but major health costs are associated with frequent home nursing visits, community nursing services being the main providers of care. An estimate was made of the prevalence of chronic leg ulcers in a cross‐sectional random sample of noninstitutionalized older people living in a major Australian city (N= 1,050). The prevalence estimate is compatible with estimates of 1 % in the over‐60 age group found in Swedish and Northern American studies. Age‐adjusted gender ratios demonstrate slightly higher prevalence in females than males (1.25:1). Implications for community nursing services for primary, secondary, and tertiary prevention are outlined and include education programs for seniors dispelling myths that leg ulcers are a natural part of aging, screening for venous and arterial peripheral vascular disease in the older community, collaborative nurse and podiatrist foot care clinics, and the location of leg ulcer clinics in geriatric day care centers.
Building Community Capacity for Health Promotion: A Challenge for Public Health Nurses
Authors: Kang Rebecca
Published: May 2007

Abstract The centennial celebration of public health nursing is a strong reminder of the tradition and practice of public health nursing's commitment to communities. Partnerships with communities give public health nurses fiduciary responsibility to be actively involved in public health reform to advance health promotion and health protection. Public health nurses must rise to the challenge to build community capacity through facilitating community participation, enhancing community health services, and coordinating public policy to achieve core public health responsibilities of assessment, policy, and assurance. This paper explicates strategies for building community capacity for health promotion.
HIV‐Related Concerns and Educational Needs of Public Health Nurses in a Rural State
Authors: Highriter Marion E. , Tessaro Irene , Randall‐David Elizabeth , Quade Dana E. A.
Published: May 2007

Abstract An anonymous questionnaire was completed by 369 nurses in public health departments in a rural Southeastern state to examine the relationship between nurses' prior HIV training and their HIV‐related knowledge, attitudes, concerns, and perceived training needs. The survey was conducted in three predominantly urban counties with the highest number of AIDS cases and in 38 rural counties with two or fewer reported AIDS cases. Knowledge answers were generally 70%‐90% correct and attitudes more favorable than unfavorable. Attitude was more frequently associated with HIV training level than was knowledge. Concerns about working with persons with high‐risk behaviors were expressed by more than half the nurses and were more prevalent in rural areas. Nurses with more training had more concerns about client care and fewer fears about HIV work. Almost all (85%) were concerned about lack of community resources. Most nurses wanted more training of the client‐sensitive type provided by the state. With the increasing incidence of HIV/AIDS in rural areas, planning continuing education for staff not only on new developments and current therapies (desired by 98%) but on managing feelings about clients with high‐risk behaviors seems especially important not only for the staff, but for their significant others and communities.
Chattanooga Creek: Case Study of the Public Health Nursing Role in Environmental Health
Authors: Phillips Lynelle
Published: May 2007

Abstract Public health nurses have two primary roles in protecting their communities from hazardous substances: community assessment and health education. Developing assessment skills in environmental health enables public health nurses to collaborate with other federal, state, and county agencies in identifying public health hazards and making health‐based recommendations at hazardous waste sites needing remedial or removal interventions. Community health education empowers communities to minimize their exposure to hazardous wastes in their environment. Methods for community environmental health assessment and interventions are demonstrated in this article by activities conducted at the Chattanooga Creek site in Chattanooga, Tennessee. A thorough assessment and collaborative approach between government agencies, local health professionals, and community members resulted in a successful community health education program and this site's placement on the National Priorities List.
Community Partnership Primary Care: A New Paradigm for Primary Care
Authors: Courtney Reni
Published: May 2007

Abstract Primary care has become the focal point of health care reform. For too long primary care has been narrowly conceptualized as office‐based care for common problems of individuals. In this article, a nurse practitioner describes a new model for primary care, community partnership primary care (CPPC), which moves beyond typical primary care practice to create what may be a new paradigm for primary care. This proposed new paradigm moves beyond older models of primary care into new dimensions of practice. The CPPC model emphasizes new roles for clinicians and a unique goal to foster the empowerment of individuals, families, and community. Innovative features of the CPPC model include blending a clinical role with a new area of practice called community practice. CPPC emphasizes new, innovative roles for nurse practitioners and nurses in community development and community empowerment activities. A 4‐year funded project permitted the development and implementation of the CPPC model in an urban Hispanic community. This article provides an overview of the CPPC model and the initial steps of model implementation.
Effects of Sustained Nurse/Mother Contact on Infant Outcomes Among Low‐Income African‐American Families
Authors: Barnes‐Boyd Cynthia
Published: May 2007

Abstract This study examined the effect on infant morbidity and mortality of sustained nursing contact with mothers of healthy infants who are considered medically low risk but socially are at high risk due to poverty, low maternal education, and parenting at an early age. A quasi‐experimental approach using a pretestposttest design was used to evaluate the effect of the sustained nursing contact intervention (N= 97) compared with the instructions traditionally provided to the mothers of such infants (N= 48). In general, intervention and control infants did not differ on variables measuring health and development, morbidity, incidence of accidents, utilization of health care services, or immunization rates. Intervention infants scored significantly higher on advanced gross motor skills and had significantly fewer upper respiratory symptoms at the final visit. Highest morbidity was experienced by infants of teenaged mothers in the control group who had more than one infant. It was concluded that sustained nursing contact during the first eight months of infant life was beneficial to low‐income African‐American mothers, especially teenaged mothers with more than one infant. Infant morbidity and mortality were lower in both groups than would have been expected for their risk level, indicating that even minimal sustained nursing contact enhances outcomes of healthy infants at high risk for mortality and morbidity due to social factors.
Causes of Alcoholism: A Qualitative Study of Traditional Muscogee (Creek) Indians
Authors: Wing Donna Marie , Thompson Timmy
Published: May 2007

Abstract Traditional Native American people are experiencing serious health, economic, and social problems resulting from alcoholism. Native Americans maintain a worldview of health and illness that conflicts with the dominant culture's approach to treatment. The purposes of this study were to describe the health beliefs of traditional Muscogee (Creek) Indians concerning the causes of illness and learn how these beliefs relate to alcoholism. The researchers conducted in‐depth interviews of 55 traditional Muscogee (Creek) participants to learn traditional beliefs about illness and alcoholism. Data were analyzed using content analysis. Results indicate that both illness and alcoholism are perceived as having natural and unnatural (supernatural) causes. A challenge facing nurses is how to provide culturally sensitive care when clients' and nurses' beliefs about the cause of alcoholism may be in conflict. The authors discuss preservation, accommodation, and repatterning of health care beliefs as a basis for planning culturally sensitive nursing care.
Use of Public Health Nursing Services: Relationship to Adequacy of Prenatal Care and Infant Outcome
Authors: Baldwin Kathleen A. , Chen ShuPi C.
Published: May 2007

Abstract Timing of initial public health nurse contact and number of nurse contacts were examined for their relationship to adequacy of prenatal physician care, infant birthweight, and gestational age. Three historical cohort groups were drawn from three downstate Illinois counties: 1) public health nursing clients (N= 506); 2) Women, Infant, and Children Nutrition Program clients (N= 314); and 3) clients receiving neither of these services (N= 403). Data were obtained from local health department records and a state birth certificate data tape. Descriptive statistics and logistic and multiple regression were used to analyze data. Timing of initial public health nursing contact was significantly correlated to adequacy of prenatal physician contact and infant gestational age. No relationship was found between either timing of initial public health nursing contact or number of these contacts and infant birthweight. The number of public health nursing and physician contacts exerted an additive effect on birthweight and gestational age. Findings lend support for case‐finding activities that result in public health nursing contacts early in pregnancy. The importance of multidisciplinary approaches to prenatal care is suggested.