bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Hypertension Risk Factors Among Hispanic Americans
Authors: Bray Martha L. , Edwards Linda H.
Published: May 2007

A program of blood pressure screening, education, and follow‐up was established to meet concerns that Hispan‐ics were at risk for hypertension and related health problems, including access to health care and information. The program provided opportunities to gather data on hypertension risk factors and general health status of the Hispanic population. Bilingual community workers provided blood pressure screening through a door‐to‐door survey of 3399 adults. In addition, the workers provided general and preventive hypertension education, obtained health histories, and referred identified health problems. All 203 persons identified with hypertension were assessed further and followed by public health nurses. Of these, 67 were referred to physicians for care. Referrals for other types of health problems were made for 1603 persons. Significant risk factors identified for hypertension were excessive alcohol intake, obesity, and frequent use of processed foods. A total of 871 persons reported at least one symptom of stress.
Community Health Nursing Audit: Issues Encountered During the Selection and Application of an Audit Instrument
Authors: Edwards Nancy , Pickard Laura , Berkel Colleen Van
Published: May 2007

Abstract Several issues were encountered by nurse‐managers in a community agency while implementing an audit of community health nursing charts. They included the following: (1) what is the purpose of the audit? (2) are the required resources available to implement the audit process? (3) what is the selection process for charts to be audited? (4) how many charts have to be audited? (5) is the audit tool based on relevant and measurable criteria and standards? (6) have the measurement properties of the audit tool been determined, including validity and reliability? The validity, reliability, and weighting of scores of the Craig audit tool are explored. Results of an assessment of this tool's reliability are presented.
Epidemiology and Biostatistics Content in Baccalaureate Education for Community Health Nursing
Authors: Erickson Grace P.
Published: May 2007

Abstract Community health nursing leaders recommend including epidemiology and biostatistics in baccalaureate curricula but do not define essential content. Topic coverage and emphasis vary across schools; students differ in academic achievement and in readiness for an epidemiologic approach to nursing. A review of textbooks showed wide variance in topic presentation. A survey of baccalaureate community health nursing faculty in a southeastern state uncovered a core of epidemiology course work comparable to that in graduate programs. Biostatistical content was sparse, and participatory learning strategies were seldom noted. Definition of essential introductory epidemiology and biostatistics content and greater linkage between knowledge and application is necessary to show their congruence with community health nursing practice, and enable differentiation between the level and scope of learning appropriate for undergraduate and graduate education.
Home Care During the Aftermath of Hurricane Hugo
Authors: Chubon Sandra J.
Published: May 2007

Abstract During the course of field observations for an ethnographic study of home care nurses' job stress. Hurricane Hugo struck the community, causing extensive damage. The nurses' office building was heavily damaged by wind and water, and their office was not habitable for almost a week. The author had observed the nurses' work practices over 10 weeks before the hurricane. In the aftermath of the storm, the nurses were simultaneously disaster victims and caregivers for other victims. They experienced grief, anger, and frustration about their losses, as well as conflict between their family‐ and work‐related responsibilities. Their experiences and behaviors were consistent with those described in prior disaster research literature, lending further support to the earlier studies. A major asset for these nurses was their open, supportive work environment. They were able to accept and affirm one another's negative feelings and to provide support to each other as they dealt with their losses.
Registered Nurses' Perceptions of Their Communication with Spanish‐Speaking Migrant Farmworkers in North Carolina: An Exploratory Study
Authors: Padgett Roslyn , Barrus Anne Griffith
Published: May 2007

Abstract Communication forms the foundation for all that nurses do. Recently, nurses working with migrant farmworkers have become challenged as the language of this population has become predominantly Spanish. To explore how nurses in North Carolina are managing communication issues, 55 nurses at 12 state health care agencies that serve migrant farmworkers was surveyed. Data were collected to determine what nurses believed about various communication issues involving these Spanish‐speaking clients, including how they were presently communicating with them, in what areas of nursing functions they believed communication barriers were problematic, what they were doing to improve their communication, and what they envisioned the potential solutions were concerning communication barriers. Language differences proved to be substantial barriers to adequate nursing care for these individuals. Nurses cited many problems and said that they were receiving little assistance from their agencies to improve direct communication with the clients. Responses indicated a need for and a willingness by nurses to focus on improving communication with Spanish‐speaking clients. Classes held at their agencies were seen as the most effective way of learning Spanish.
Social Networks and Social Support of Recently Divorced Women
Authors: Duffy Mary E.
Published: May 2007

Abstract A study of the support networks and social support of recently divorced women with children was conducted over two years. Its purpose was to assess changes in the women's social support and identify their unmet needs. Data were collected from 148 women by mailed questionnaire and telephone interview soon after the final divorce decree, and again at two years. The women did experience a significant decrease in network size and social support over two years; however, the primary members of their networks—family and friends—remained stable. Women with preschool‐age children had more family support than those with older children. Nine categories of unmet needs were identified. Most frequently cited, in descending order, were emotional support, financial assistance, need for a boyfriend/partner/spouse, time for herself, and child care. The average number of needs per woman was less than two. The findings of this study confirm the losses in overall network size and support that women experience after divorce. The identification of unmet needs helps nurses to target areas in which women may require assistance to find social support.
Definitions of Health and Health Goals of Participants in a Community‐Based Pulmonary Rehabilitation Program
Authors: Folden Susan L.
Published: May 2007

Abstract Improving health is the goal of community‐based rehabilitation programs. However, different conceptions of health between health care providers and participants inhibits communication, leads each group toward different goals, and causes dissatisfaction among participants who feel their individual goals are not being met. This study compared definitions of health, and the health goals of participants in a nurse‐managed community respiratory rehabilitation program with those of the program. The majority of 132 adults with chronic respiratory disease defined health in terms of absence of disease and its symptoms, or as the ability to function within the community. Their goals paralleled their definitions. Most participants hoped to decrease the symptoms of their disease or to improve their functional ability. Their goals were reflected in the program's goals; however, the definition of health held by the multidisciplinary team directing the program was broader than those expressed by most participants.
The Difficult First Week at Home With a Premature Infant
Authors: McKim Edna M.
Published: May 2007

Abstract The results reported were obtained from the findings of a larger descriptive study that surveyed the support needs of 56 mothers of high‐risk premature infants. Forty‐eight percent of the mothers found the first week after their infant's discharge home difficult. Data analysis indicated the more premature the infant (birth weight r= 0.29, P= 0.03; gestational age r= 0.34, P= 0.008), and the greater the severity of illness as determined by length of hospital stay (r= ‐0.27, P= 0.04), the more likely the mother was to have a difficult first postdischarge week. The visit of the community health nurse during that first week was a significant factor in whether the mothers perceived the time as difficult (Fisher's exact test, P= 0.02). It was found, as well, that the community health nurses were less likely to visit mothers of very low‐birth‐weight infants during that week (Fisher's exact test, P= 0.02). Other variables related to difficulty during the first week were whether the infants had apnea in hospital (r= 0.33, P= 0.01), mothers' need for specific kinds of information such as knowledge about colic (X2= 24.31, df= 12, P= 0.02), and an earlier scheduled visit to a physician for mothers whose infants were of lower birth weight (r= ‐0.26, P= 0.05), earlier gestational age (r= ‐0.34, P= 0.009), and had spent longer time in hospital (r= 0.37, P= 0.006).
Lillian D. Wald: Progressive Activist
Authors: Coss Clare
Published: May 2007

Following are two excerpts from Lillian D. Wald: Progressive Activist
A Model of Health Care Delivery in a Child Day‐Care Setting
Authors: Gaines Sherry K. , Rice Marti S. , Carmon Myra C.
Published: May 2007

Abstract Many children in our country spend all or part of their days in group day care while their parents work or go to school. These children are not only at risk for day‐care‐related illnesses, but also may lack preventive health care because their parents have time constraints or financial barriers. A group of nursing faculty members found that by collaborating with early childhood educators, accessible and cost‐effective health care could be provided to children at a campus day‐care site. This collaboration allowed for the early detection of problems, thereby reducing barriers to learning. Furthermore, by entering a day‐care system, nurses found opportunities to conduct health education and promotion that had a positive impact on children, parents, and day‐care staff. This model, or components of it, could be replicated in similar settings.
Description of the Clinical Practice of Advanced Practice Nurses in Family‐Centered Early Intervention in Two Rural Settings
Authors: Kang Rebecca , Barnard Kathryn , Oshio Sachiko
Published: May 2007

Abstract The purpose of this study was to describe the scope of clinical practice of advanced pratice nurses who were involved in a project designed to increase access of families with at‐risk and disabled young children, newborn to 3 years of age, to early intervention services in rural Washington State. The findings from this study are based on the retrospective review of records of clients seen by the advanced practice nurses. Nursing diagnoses and nursing interventions were assigned to chart recordings. The most frequently occurring nursing diagnoses assigned to parents were Altered Parenting, Altered Family Processes, Fear, Noncompliance, and Knowledge Deficit. The most frequently occurring nursing diagnoses assigned to children were Impaired Physical Mobility. Impaired Verban Communication, Altered Nutrition: Less than Body Requirements, Sensory‐Perceptual Alteration, and Altered Thought Processes. Categories of nursing intervention recorded most frequently were Monitoring, Planning and Information. Discussion of findings addresses the roles and reimbursement of advanced practice nurses who provide family‐centered early intervention services in rural communities.
An Information Manager for the Assessment Protocol for Excellence in Public Health
Authors: Vaughn Edward H. , Richards Thomas B. , Christenson Gregory M. , Taylor Marcia S. , Eyster Janet
Published: May 2007

Abstract The Assessment Protocol for Excellence in Public Health (APEXPH) is a method for comprehensive public health planning that can be implemented by state and local health departments. Many local health departments have limited resources for the data analysis and synthesis needed for APEXPH. To facilitate the implementation of APEXPH in Michigan, we used the Centers for Disease Control and Prevention (CDC) Epi Info software package to develop an APEXPH information manager (CDC‐AIM) for use by the 50 local health departments in that state. This report describes our methods for formatting, compressing, and presenting data. Examples of tables are provided for demographics by age and sex, numbers of deaths, years of potential life lost, crude mortality rates, and perinatal indicators such as low birthweight. Areas where additional work is needed to further improve CDC‐AIM are discussed. Our experience in Michigan suggests that CDC‐AIM potentially is an extremely helpful tool to assist state and local health departments in working with their communities to establish public health program plans based on mortality, morbidity, and risk‐factor data.
Community Health Clinical Experiences: The Primary Care Setting
Authors: Kemp Charles
Published: May 2007

Abstract Applying the nursing process to the health of populations is a challenge in undergraduate community health nursing education. We evaluated a method of applying the process in primary health care settings. Key factors were using case management and other means to assess systems from the client's perspective, assessing population needs, diagnosing community needs‐service mismatch, planning in partnership with communities, and implementing and evaluating plans. Because these are difficult, if not impossible, to accomplish in a one‐semester undergraduate course, students transferred projects and cases from one semester to another. Case management is the principal interface of students to individual and family clients.
A Primary Health Care Approach Using Hispanic Outreach Workers as Nurse Extenders
Authors: Bray Martha L. , Edwards Linda H.
Published: May 2007

Abstract In an effort to improve the health of Hispanic families, particularly prenatal women and infants, the county health department instituted a program of intensified home visits using bilingual, bicultural nurse extenders within a framework of primary health care. The outreach workers offer basic health information to improve families' skills and knowledge, and to assist with linkages to community resources. Public health nurses provide assessment, establish a plan of care, evaluate progress, and supervise the workers. The program has resulted in increased numbers of individuals receiving services, more women registering earlier for prenatal care and the Women, Infants, and Children's (WIC) program, and increased numbers of infants receiving WIC services and regular medical supervision. Public health nurses report increased knowledge and positive changes in families' health behaviors. In addition, the program has strengthened relationships between the health department and Hispanic families.
Beyond Rhetoric: Building and Achieving Community Consensus in Planning and Developing an Innovative Public Health Nurse‐Midwifery Education Program
Authors: Douglas Gail H. , Robbins Whitney K. , Sullivan‐Paal Christine
Published: May 2007

Abstract Program planners collaborated with communities to achieve the goal of increasing the number of public health‐educated nurse‐midwives, and thus improve women's access to health services. By developing an innovative master's degree in public health nurse‐midwifery education program, Boston University School of Public Health revitalized a model first developed at Johns Hopkins University School of Hygiene and Public Health. The dearth of nurse‐midwifery education programs in the Northeast, coupled with the critical deficit of obstetric providers, had contributed to an alarmingly high infant mortality rate in Boston. This academic program is an exciting alternative for meeting the health care needs of mothers and children and achieving the year 2000 objectives for the nation. Such a program, coupled with a foundation in public health education, synthesizes the best in nursing, nurse‐midwifery, and public health. Graduate nurse‐midwives will have an enhanced understanding of the health care delivery system, the causal factors that contribute to disease, and the environmental, legal, and management dimensions surrounding the delivery of care.
Lena Angevine Warner: Pioneer Public Health Nurse
Authors: Greenhill E. Dianne
Published: May 2007

Abstract Lena Angevine Warner was a remarkable early southern nurse who, as a result of her Army experience with the Walter Reed Commission yellow fever experiments in Cuba, directed her life work to disease prevention and public health. This biographic sketch traces her long and productive career from 1889 until her retirement in 1946, and illustrates her significant contributions to public health nursing in the mid‐South.
Unintentional Infant Injuries: Sociodemographic and Psychosocial Factors
Authors: Harris Mary J. , Kotch Jonathan B.
Published: May 2007

Abstract
This prospective study sought to identify sociodemographic and psychosocial risk factors for unintentional infant injuries that occurred in or around the home. It also examined whether social support modified the relationship between high maternal stress and infant injury. The subjects were 367 mothers who were interviewed six to eight weeks after their newborn infants were discharged from the hospital, and approximately one year later, when 132 infants (36%) were reported as injured (burned, poisoned, serious fall, airway problem). Logistic regression analyses established that family conflict was the most significant predictor of unintentional infant injury, followed by fewer than two siblings living in the home at the first interview, and maternal unemployment. In addition, among mothers with high stress, the use of social support resulted in fewer unintentional infant injuries.
Culture Sensitivity in Assessing Urban Native American Parenting
Authors: Seideman Ruth Young , Williams Roma , Burns Paulette , Jacobson Sharol , Weatherby Francene , Primeaux Martha
Published: May 2007

Abstract
Assessing urban Native American (NA) parenting remains a challenge for public health nurses. This study explored the effectiveness of using the NCATS and HOME instruments with urban NA mothers and their children. Scores for 63 sets of mothers and their children age 3 months to 3 years on the home observation for measurement of the environment (HOME) and nursing child assessment teaching scale (NCATS) instruments were compared with norms for those instruments. Scores were lower than the norms on the play and involvement subscales of the HOME, and higher than the norms on the total parent, clarity of cues, response to parent, and total child subscales of the NCATS. Analysis of responses to specific items indicated that these mothers were unlikely to structure and intervene in children's activities and likely to use nonverbal parenting techniques. Findings supported the usefulness of these instruments with NA parents when accompanied by discussion of findings with them, and nurse awareness of common family structures and traditional values.
Policy Research: Lessons from the Field
Authors: Rains Joanne W. , Hahn Ellen J.
Published: May 2007

Abstract Nursing's involvement in policy development has become a standard and expected part of nursing practice. One avenue of involvement, policy research, is clarified through description and case example. Policy research is described as context‐driven, multimethodological, and time‐sensitive. Considering these essential characteristics when planning and implementing policy research enhances nursing's ability to positively influence the policy process. A case example of policy research from the criminal justice system evaluated the effectiveness of a diversion program with alcohol and marijuana misdemeanants (N = 1,239). The purposes of the study were to describe the percentage of diversion participants with alcohol or marijuana‐possession charges who were successful in completing the diversion program and to examine the incidence of subsequent arrests on alcohol or marijuana‐possession charges among those who successfully completed the program. The case example demonstrates the intricate and unique relationship between research and the policy arena. Policy research can equip nursing to enter policy debates with data and to participate as a persuasive agent of social change.
Reliability and Validity of the Smoking and Women Questionnaire among Three Ethnic Groups
Authors: Gulick Elsie E. , Escobar‐Florez Libia
Published: May 2007

Abstract Cigarette smoking among women continues to be a major health risk to the smoker and to those around her. Programs aimed at stopping and maintaining smoking cessation have had very limited success due in part to the failure to individualize smoking cessation programs based on specific characteristics of the smoker. This study presents reliability and validity of a 14‐item questionnaire developed to determine the readiness of women from three ethnic groups (non‐Hispanic white, black American, and Hispanic American) to stop smoking. The Smoking and Women Questionnaire (SWQ) consists of items representative of core elements conceptualized in the Smoking/Ex‐smoking Model for Women. The core factors are: beliefs/attitudes toward smoking, sociability, stress, coping, self‐efficacy, motivation, nicotine dependence, and support. The SWQ was completed by both smoking and nonsmoking non‐Hispanic white (N= 233), smoking and nonsmoking black American (N= 70), and smoking and nonsmoking Hispanic American (N= 73) women. The test‐retest correlation coefficient over a one‐ to three‐week period (N= 53) was .84. Cronbach alphas for whites, blacks, Hispanics, and combined groups were .81, .85, .84, and .83, respectively. Content validity was shown by experts who agreed that the core elements were represented in the SWQ. Construct validity was shown for ethnic groups separately and combined in that smokers had significantly lower SWQ scores than non‐smokers. Items representative of the core elements were rated by smokers in a similar manner irrespective of ethnicity, suggesting similar attitudes and behaviors toward smoking. Further research is needed to determine if the SWQ can predict readiness of women to stop smoking and serve as a basis for developing individualized smoking cessation programs. Implications for smoking cessation programs are reviewed.
The Georgia Rural‐Based Nurse Model: Primary Care for Persons with HIV/AIDS
Authors: Sowell Richard L. , Opava William D.
Published: May 2007

Abstract The need for specialized HIV education for nurses working in rural areas will increase as the incidence of HIV infection increases in rural areas. Public health nurses provide a viable alternative to providers in acute care facilities and will continue to be the primary care providers for persons with HIV/AIDS in rural areas. While approaches to HIV/AIDS education should include clinical treatment as the core, clinical knowledge alone will not promote the development of caring communities. The Rural‐Based Nurse Model provides a comprehensive curriculum that addresses the many complex issues associated with the care of persons with HIV/AIDS. Additionally, participants are linked with care providers who serve clients across the continuum of HIV disease. Through meaningful educational opportunities and provider networking, this program has the potential for improving the quality of care in rural areas for persons with HIV/AIDS. HIV/AIDS education programs will require individualized community strategies that consider existing resources and barriers. However, the Rural‐Based Nurse Model provides a formula for HIV/AIDS education that can be easily adapted to other settings.
Abuse during Pregnancy: Frequency, Severity, Perpetrator, and Risk Factors of Homicide
Authors: McFarlane Judith , Parker Barbara , Soeken Karen
Published: May 2007

Abstract To determine the frequency, severity, and perpetrator of abuse during pregnancy as well as the occurrence of risk factors of homicide, a stratified, prospective cohort analysis was completed on 1,203 African‐American, Hispanic, and Anglo women in urban public health prenatal clinics. All women were assessed for abuse at the first prenatal visit and twice again during the pregnancy. All women were administered the Conflicts Tactics Scale, the Index of Spouse Abuse and the Danger Assessment Scale. Prevalence of physical abuse during pregnancy was 16%, one in every six women. Women abused during pregnancy had significantly higher scores on all instruments and more risk factors of homicide when compared with women abused prior to but not during pregnancy. To protect women's safety, a protocol of assessment and intervention for abuse must be standard care for all pregnant women.
Developing a Collaborative Community Partnership Program in Medical Asepsis with Tattoo Studios
Authors: Bechtel Gregory A. , Garrett Christina , Grover Susan
Published: May 2007

Abstract The possibility of transmission of infectious agents during tattooing has become a legitimate issue of concern for health care providers. A collaborative educational program was developed by a county health department, College of Nursing, and tattoo artists to address issues of medical asepsis with the goal of producing a mechanism for certification of tattoo studios. The group's effort was enhanced by recognizing each other's value systems and by the mutual need for a successful program. A framework for developing, implementing, and evaluating community partnerships was addressed. This program demonstrated that community health nurses can play an instrumental role in collaborating with both health care providers and personal‐service workers to minimize transmission of infectious agents during cosmetic procedures.
Sensitizing Nurses for a Changing Environmental Health Role
Authors: Tiedje Linda Beth , Wood Joan
Published: May 2007

Abstract This paper traces the evolution of a broader environmental health role for nursing by focusing on the health effects of exposure to environmental pollutants and of global environmental change. This evolving role is reviewed through the examination of selected community health nursing texts published during the last several decades. Key role strategies based on this expanded and evolving environmental role are proposed. Finally, a survey is described that is intended to heighten awareness of personal and professional attitudes and behaviors related to the environment.
A Study of Public Health Nursing Directors in State Health Departments
Authors: Stevens Rachel H.
Published: May 2007

Abstract Public health nurses make up the largest single category of public health manpower, but confusion over where and how public health nurses should function continues. The purposes of this study were to describe the current structure of public health nursing in state health departments in the United States, and to note whether this structure had changed over the last 5 years. Data were collected through a survey sent to each of the 50 U.S. State Health Departments. Forty‐eight percent of the 50 states responded to the survey. From the results, we can conclude that there is currently no uniform description of what states expect of their state nurse directors, even though these individuals lead the largest portion of the public health workforce. The public and the public health system place a large, but often unwritten and unspoken, expectation on public health nurse leaders, but in recent years erosion has occurred in public health nursing in many states. Public health nursing is well positioned to provide leadership under health care reform. The challenge now facing public health nursing leaders is to maintain or create the infrastructure, as well as the organizational culture, to maximize these opportunities.
Power and Opportunity in Public Health Nursing Work Environments
Authors: Haugh Flizabeth Battle , Laschinger Heather Spence
Published: May 2007

Abstract Kanter's structural theory of power in organizations provided the conceptual framework for this comparative study on perceptions of power of two levels of nurses working in three public health agencies during a time of program transition. Forty‐six public health nurses and 10 nurse managers were surveyed to examine their perceptions of the amount of power existing in their own and their counterparts' jobs. Propositions from Kanter's theory were supported by the data. Both groups rated their work environments to be somewhat low in power, although managers perceived themselves to be significantly more empowered in their work environments than did staff nurses. In addition, staff nurses perceived themselves to have significantly less access to empowerment structures (opportunity, information, support, and resources) than their managers perceived them to have. Staff nurse empowerment was found to be significantly related to perceptions of their immediate managers' power in the organization.
Walking the Journey of Womanhood
Authors: Strickland C. June , Chrisman Noel J. , Yallup Martha , Powell Kolynn , Squeoch Marion Dick
Published: May 2007

Abstract Cervical cancer is the second leading cancer among Alaska Native. American Indian women, who have a high incidence of cervical cancer and low survival rates (Boss, 1991; Michalek & Mahoney, 1990; Page & Asire, 1985). The purpose of this Grounded Theory study was to gain a greater understanding of the meaning of the papanicolaou (Pap) test to the Yakama Indian women of eastern Washington to support the Tribe in the design of effective screening interventions. Data from 15 interviews, focus groups, and participant observation were included in the data analysis. The major theme was: Walking the Journey of Womanhood. Four phases of the journey were identified: (a) Starting the Journey, (b) Blooming, (c) Heading the Household, and (d) Becoming an Elder. In this study we found that interventions to influence Pap test screening among the Yakama women must address structures of care, provider‐patient communications, and education for the women. Women heading the households and elders were identified as priority populations for education because they have negative attitudes from previous experiences and have a great influence on the younger women. Messages need to be wellness oriented and traditional methods of education, such as the talking circle, role model, and storytelling, need to be used.
Nursing Diagnoses and Home Care Nursing Utilization
Authors: Marek Karen Dorman
Published: May 2007

Abstract The purpose of this study was to identify, from routinely collected health care record data, patient characteristics that describe home care clients' health care needs and explain variation in home health care utilization. Retrospective data were obtained from a total of 317 home health care patient records from one home health care agency. Outcome variables of care included number of visits and hours of care. Predictor variables included nursing diagnoses, medical diagnoses, and patient demographic variables. Nursing diagnoses were classified by the Omaha System. Nursing diagnoses explained a significant amount of variance over and above the demographic and medical diagnosis variables in both the number of nursing visits and hours of nursing care. The results of this study suggest that data related to nursing diagnoses are a valuable source of information when examining home health care nursing resource use.
Issues Inherent in Measuring the Impact of Care Coordination on Pregnancy Outcomes
Authors: Bradley Patricia J. , Martin Joanne
Published: May 2007

Abstract Care coordination is a Medicaid benefit designed to help low‐income women gain access to pregnancy‐related services. Measuring the outcomes of care coordination is hampered because experimental designs are difficult to carry out on entitlement programs. The purpose of this study was to examine whether a care coordination‐adequacy index, based on number of home visits, onset of home visits, and weeks' gestation at delivery, would outperform a simple count of the number of home visits in predicting birthweight. Data from a pilot project in Indianapolis were used. The adequacy index outperformed “number of home visits” in the prediction of birthweight with this sample. Those who received intermediate level of care coordination delivered infants weighing 162 g more than those who received inadequate care coordination. The adequate level of care coordination did not predict birthweight, which may have resulted from an insufficient number of participants in this category (n= 20). An inherent selection bias based on the length of gestation when admitted to the program is also discussed. Research on care coordination with clear delineation of the measurement issues involved must continue to ensure effective program design and continued funding.
Comprehensive Interdisciplinary Care
Authors: Pearce Carole W. , Hawkins Joellen W. , Carver‐Chase Dorothy , Ebacher Rosamunde , Matta Susan , Sullivan Amy , Vawter Victoria J. , Vincent Cheryl , Windle Karen A.
Published: May 2007

Abstract Hispanic women constitute one of the fastest growing and most diverse groups in the United States, representing many countries of origin and cultural practices. The purpose of this evaluation study, using an ex post facto design, was to examine well‐being during pregnancy and pregnancy outcomes for a cohort of 113 Hispanic women receiving perinatal care at the clinic of a community hospital in an old industrial city in the Northeast. The received adequacy of prenatal care for the study sample women was very high. The low‐birthweight rate was lower than for the study hospital, the study city, the state, and the entire United States. The results of this study demonstrate the favorble effects of a comprehensive, interdisciplinary, and culturally sensitive model of prenatal care on these women's well‐being and birth outcomes. Findings also support the need for an outreach program targeted at hard‐to‐reach women in the inadequate, received‐care group and women with later initiation of care.
Rural Sex Education
Authors: Polivka Barbara J.
Published: May 2007

Abstract The purposes of this study were to assess the sex education programs offered in three rural Ohio counties, the agencies involved, and the extent to which agencies collaborated, and to compare interagency collaboration across counties. This cross‐sectional study occurred in two phases. Using key‐informant interviews (n= 85), Phase 1 identified current programs. Phase 2 assessed interagency collaboration via a mailed survey (n= 116). Results indicated that there were five to nine sex education programs per county, each involving five to eight agencies. Sex education was offered inside and outside of schools; programs were available to keep pregnant/parenting youth in school, enhance self‐esteem, provide parenting education to teens, and advocate for abstinence. Sex education also occurred via a newsletter and an adolescent health conference, and in various clinics. Minimal collaboration was noted among agencies providing these programs. Public health nurses are ideally situated to identify current programs and agencies involved and form an interagency group to plan and implement comprehensive, collaborative sex education programs for youth. Further research is needed to longitudinally assess the impact of such program development on interagency collaboration, teen sexual activity, and pregnancy rates.
Health and Social Support Among Older Women in Congregate Housing
Authors: Lough Mary Ann , Schank Mary Jane
Published: May 2007

Abstract This study of community‐dwelling elderly women found that perceptions of positive health status and adequate social support do not decline with age, even among the old old. The relationship between health status and social support reflects the reciprocal nature of person and environment found in the ecologic model.
The Effects of Daily Hassles on Exercise Participation in Perimenopausal Women
Authors: Evans Martha Swann , Nies Mary A.
Published: May 2007

Abstract Exercise is a key factor in the prevention of many chronic conditions. There are gaps in the research pertaining to social roles, daily hassles women experience, and exercise participation. The purpose of this descriptive study was to examine the effects of daily hassles, age, and race on regular physical activity in perimenopausal women. This study utilized a convenience sample of 35 women aged 35‐55 from a large southern university. The Exercise subscale of the Health Promoting Lifestyle Profile (HPLP), a 5‐item Likert scale, was used to measure exercise participation. Daily hassles were measured using the 53‐item hassles portion of the Hassles and Uplifts Scale. Age and race were also collected from each participant. There was no statistically significant interaction between overall hassles scale scores and Exercise scale scores. There was, however, a statistically significant effect of the Household subscale on exercise. The Environmental and Social Issues subscale with race had an effect on exercise participation, although neither of these variables alone had any effect. Further understanding of the effects of daily hassles on exercise participation in women will help nurses to develop client‐centered exercise programs to better assist them in changing lifestyle behaviors.
TB or Not TB? Increasing Door‐to‐Door Response to Screening
Authors: Clark Patricia A. , Cegielski J. Peter , Hassell Willis
Published: May 2007

Abstract Tuberculosis (TB) has made a disconcerting comeback in the United States in recent years. In 1994, Texas ranked third nationally in total number of TB cases and fifth in annual TB case rates. This is of great concern to the Texas Department of Health (TDH) and has led to the development of TB Innovative Demonstration Projects under the Tuberculosis Elimination Division of the TDH. One such project involves identifying high‐risk communities by utilizing a computer‐based geographic information system and then sending field‐workers door‐to‐door offering free skin testing. Because this project was so successful in identifying positive skin test reactors, numerous requests have been made to duplicate its methods. One area of improvement is to increase individual and family participation. The purpose of this article is to present a survey of the literature on nonresponse in door‐to‐door soliciting, analyze the project's methods of soliciting and nonresponse, and propose ways nonresponse can be decreased in future projects of this nature.
Resources, Stigma, and Patterns of Disclosure in Rural Women with HIV Infection
Authors: Sowell Richard L. , Lowenstein Arlene , Moneyham Linda , Demi Alice , Mizuno Yuko , Seals Brenda F.
Published: May 2007

Abstract A growing number of cases of HIV infection are being diagnosed in rural communities especially among women. Although HIV‐specific education and care delivery programs have been focused on rural areas in recent years, limited data are available on the impact of such initiatives on the lives of women with HIV infection. The purpose of this study was to examine characteristics of women with HIV disease living in rural communities. The study used a cross‐sectional sample of rural women in Georgia. Data analysis indicated that although a majority of the women reported adequate resources, there was a group of women for whom resources for basic needs were not always adequate. Additionally, women with HIV who had not progressed to AIDS had greater difficulty in obtaining a number
Indicators of Possible Lead Exposure Among Children Attending Public Lead Screening Clinics: Implications for Primary Prevention
Authors: Porter Eileen Jones , Severtson Dolores J.
Published: May 2007

Abstract Because lead exposure is a health‐related condition that precedes elevated blood lead levels, the aims of this study were to examine the prevalence of lead exposure among children attending lead screening clinics in two Wisconsin counties and to explore its relationship to demographic variables. Based on data obtained from parents, significant relationships were found between the history of possible exposure and the demographic variables of rural or urban home location, rented or owned dwelling, and family income. About 90% of the children were being exposed to at least one possible lead source. The rationale for intensive study of lead exposure's demographic context was validated, and the need for primary prevention of lead exposure was affirmed.
Identification of Needs of and Utilization of Resources by Rural and Urban Elders After Hospital Discharge to the Home
Authors: Schultz Alyce A.
Published: May 2007

Abstract The recent reductions in lengths of hospital stays may particularly affect the elderly in rural communities where resources may be scarce. The purpose of this descriptive, comparative study was to assess and evaluate the match of formal and informal resources with individual functional, behavioral, knowledge, and skilled care needs of rural and urban elderly during a 21‐day transition period following hospital discharge to the home. Eighty‐one elderly patients discharged to one urban and two frontier rural counties were selected. There were no significant differences in demographic variables between rural and urban participants. The Comprehensive Health Care Needs Assessment (CHCNA) questionnaire was used to assess needs and utilization of resources at 3 days and 3 weeks after discharge. Using repeated measure analyses of variance, there were significantly fewer needs identified at 3 weeks than at 3 days after discharge. Rural dwellers identified significantly more skilled care needs than their urban counterparts; however, none were highly technical in nature. Unexpectedly, at 3 weeks after discharge, considerably more functional needs were met by families in the urban setting than in the rural setting. Although only a small number of participants reported unmet needs in multiple domains, the complexity of the unmet needs requires further exploration.
Indoor Air Pollutants and Sick Building Syndrome: A Case Study and Implications for the Community Health Nurse
Authors: Tsacoyianis Rosemary
Published: May 2007

Abstract Indoor air pollutants and sick building syndrome are only recently gaining recognition as a public health concern. Unfortunately, however, most nurses feel ill equipped to address such environmental health issues. This article begins with a review of literature on indoor air pollutants and sick building syndrome, followed by a case study of occupant illness in a school since the onset of a school construction and renovation project. Included in the case study is an in‐depth analysis of Material Safety Data Sheets (MSDSs) and Product Data Sheets, conducted to examine the potential health effects resulting from product use in the indoor environment. The results of the analysis indicate that a significant number of products used in the project may have induced the reported occupant symptoms. The conclusion of the case study is that building occupants were exposed to multiple products that have numerous acute overexposure health effects and unknown long‐term health effects, and thereby placed occupants at an ill‐defined health risk. The review of literature and case study findings demonstrate the imminent need for community health nurses to assume a proactive role in promoting environmental health. Nursing implications are provided to guide the community health nurse's role in cases of sick building syndrome.
Reconceptualization of Community Health Nursing Clinicals for Undergraduate Students
Authors: Helvie Carl O. , Nichols Brenda S.
Published: May 2007

Abstract The multilevel community intervention model is a way of maximizing community resources and services and providing a community focus for undergraduate community health nursing students. The rationale for a change from traditional community health nursing clinical experiences to more community focused ones and current nursing standards supporting this change are identified. The model and its utilization with undergraduate nursing students is discussed. Three groups of undergraduate community health nursing students will each implement one piece of the model and through group discussions learn about the total model.
Home Health Nurses' Initial Experiences with Wireless, Pen‐Based Computing
Authors: Wilson Rachel , Fulmer Terry
Published: May 2007

Abstract Eight home health nurses from the Visiting Nurse Service of New York participated in a focus group discussion after their initial experiences using wireless, pen‐based computing in the inner‐city, home care environment. Transcripts of the nurses' responses to open‐ended questions were analyzed and central themes were found, following the method of concept analysis described by Strauss and Corbin (1990). The central concepts were “Readiness,”“A thousand pounds on my back,”“Call for support,”“Problems with transmission.”“Using the computer as an assistant,”“Nurses discovered glitches,” and “Everybody has to have a computer.” These themes reflected the nurses' initial experiences with the wireless computers and also revealed their concerns. This article will describe these themes and will discuss the implications of current improvements in wireless computing for health care. The focus group themes aided in understanding how this group of experienced home health nurses began to transition from handwriting on several different forms to checking‐off items on a small, hand‐held computer screen, from innovating methods to communicate when telephones were not available, to using a wireless computer to send and receive data involved in the patient admission process
HIV/AIDS: A Challenge in the Classroom
Authors: Grier Elaine Churchwell , R Helen F. Hodges
Published: May 2007

Abstract Public school personnel represent a significant population at risk for potential transmission of blood‐borne diseases including HIV/AIDS. Teachers, staff, and PTA clinic volunteers can be exposed to HIV/AIDS through such common classroom occurrences as nosebleeds, cuts and scratches, loss of teeth, and results of fights. According to the research literature, public school teachers and other school personnel are least often mentioned as being the target group for health education with regard to HIV/AIDS. To assess the extent to which on‐site HIV/AIDS education for school personnel increases the use of disposable gloves in the school setting, educational programs were provided to groups of teachers, staff, and PTA clinic volunteers. Each presentation included a short pretest, a brief formal presentation, and a question and answer session. A post‐test was administered three months following the presentation. Findings revealed that while factual knowledge about HIV/AIDS was evident in school personnel, there was little working knowledge of Universal Precautions, and self‐reported glove use was minimal. All schools reported an increase in glove use following the presentation.