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Purpose: The current integrative review was conducted to understand the relationship between housing and health in older adults with low income in the United States. Method: A literature search yielded 20 articles that met inclusion criteria. Key data elements were extracted from each article and a five-level social ecological model (SEM) was used as a framework to analyze the findings. Results: The analysis yielded themes associated with each SEM level: Interaction Between Housing and Personal Traits and Behaviors (individual level); Burdens and Benefits of Social Relationships (relational Level); Building Quality and Health (environmental level); Role of Housing Assistance (structural level); and Influence of Poverty and Structural and Systemic Racism (superstructural level). Conclusion/Implications: Results clarify housing's role as a social determinant of health affecting older adults with low income and may help nurses tailor patient assessments and treatment plans to better identify and address housing-related health risks. [Journal of Gerontological Nursing, 50(3), 25–32.] [ABSTRACT FROM AUTHOR]

The aim was to identify which factors facilitate providing integrated behavioral health care for Iraqi refugees in nationally recognized community health center in Northern USA. The social-ecological model (SEM) framework guided this qualitative case study exploring the experience of 11 professional staff. Data were collected from June through August 2021 through individual interviews. Eight themes emerged based on the SEM levels: Intrapersonal—gender-driven engagement; interpersonal—the need for discretion and trusting relationship; community—collaboration with community resources and integrator from the community; organizational—holistic care, and long-term care; and policy—insufficient educational preparation. The results highlight components for clinical practice and policymakers regarding a population that is a big consumer of mental health care. Future research should explore other vulnerable populations, the effect of social groups, and the incorporation of community resources as part of the integrated care team. [ABSTRACT FROM AUTHOR]

Background: Increasing numbers of opioid-overdose deaths have been witnessed among Hispanics and other underserved populations in Massachusetts. Puerto Rican adults (PRs) have a disproportionately higher prevalence of chronic diseases than non-Hispanic White adults—conditions linked to increased prescription opioid use and misuse. Stress indicators, including low acculturation, low social support, and perceived discrimination, have been recognized as correlates of chronic diseases. However, little research has been undertaken on how these socio-cultural factors relate to persistent prescription opioid use among PRs. This study evaluated the prevalence of prescription opioid use and socio-cultural factors associated with persistent prescription opioid use among PRs. Methods: Data from the prospective population-based Boston Puerto Rican Health Study, at baseline, ~2-year, and ~ 6-year follow-up, were used to estimate prescription opioid use prevalence and its associations with acculturation, social support, and perceived discrimination. Analyses were conducted using multivariable binary logistic regression modeling. Results: The study sample was comprised of 798 PRs (age 56.5 ± 7.5y) with data at all three-time points. A high prevalence of prescription opioid use was observed and was associated with lower household income. PRs with experiences of perceived discrimination had higher odds of persistent prescription opioid use (y/n; OR = 2.85, 95% CI: 1.46–5.58). No significant associations were found between acculturation, social support, and persistent prescription opioid use. Conclusion: Our study reported a high prevalence of prescription opioid use in PRs, with persistent prescription opioid use significantly associated with perceived discrimination. Future programs to limit discrimination practices may reduce persistent prescription opioid use and opioid-related complications among PRs. [ABSTRACT FROM AUTHOR]

To evaluate marginalized youth participation in a civic engagement and leadership program accompanied by a photovoice activity. This study employed an exploratory qualitative method through semistructured focus group discussions among 11 participating teens, as well as 63 photographs from the photovoice activity and their accompanied narratives. The data was coded, and themes related to teens concerns and workshop impact were summarized. Focus group and photovoice analyses showed similar themes related to the experience of participants empowerment, identity recognition, community awareness, and desire for civic engagement. Participants conveyed concerns about gender and race discrimination, community drug abuse, littering, teen pregnancy, and overcrowded schools. This study has implications for professionals and researchers engaging with marginalized teens in the community. Photovoice methodology can complement any program that has teen empowerment among their goals of allowing participants to have a voice. [ABSTRACT FROM AUTHOR]

Background: Compassion fatigue is a negative consequence impacting caregivers of chronic illness, such as heart failure. Reliance on family caregivers is expected to rise, placing importance on recognizing family caregiver characteristics that contribute to compassion fatigue. Purpose: This study specifically examined the associations of characteristics of family caregivers caring for end-stage heart failure, compassion satisfaction, social desirability, and the family caregiver–nursing provider relationship on compassion fatigue. Methods: An adapted interaction model of client health behavior guided this cross-sectional survey, which comprised a demographic questionnaire, the Professional Quality-of-Life Scale, the caregiver–provider relationship assessment, the Marlowe–Crowne Social Desirability Scale Short Form (Form C), and the Bakas Caregiving Outcomes Scale. Results: There were 127 family caregivers (FCGs), primarily those who have been a caregiver for longer than 1 year (78.4%), who completed the entire survey. Increased compassion satisfaction and positive caregiving effects were associated with decreased compassion fatigue (p <.001), while increased social desirability was associated with increased compassion fatigue (p <.001). A positive family caregiver–nursing provider relationship was related to decreased compassion fatigue (p <.001). More compassion fatigue was seen with lower spiritual status (p <.001). Implications: The chronic progression of heart failure presents opportunities for nursing providers to assess caregivers and offer frequent interventions. Family caregivers may not ask for help. Nursing providers must foster relationships with family caregivers to prevent negative consequences and mitigate compassion fatigue. Future research on the nursing provider relationship and FCGs is needed. [ABSTRACT FROM AUTHOR]

The integrated behavioural health care (IBHC) model incorporates mental health services with primary care. This service model is widely advocated due to its increasing access to health care and cost‐saving. By connecting individuals with mental illnesses with a primary care provider, this model of care promotes collaboration between interdisciplinary teams, and therefore, increases health equity, decreases stigma, and increases patient satisfaction. This integrative review aimed to examine and synthesize available literature on facilitators and barriers related to the IBHC model implementation in the United States. An integrative review methodology by Whittemore and Knafl was utilized, and data evaluation was based on the JBI Critical Appraisal Checklist. The social‐ecological model guided the review. Twenty‐two articles were analysed, and nine themes were identified, which were further organized according to the five levels of the social‐ecological model and consisted of intrapersonal level – patient‐centered care; interpersonal level – relationships; community level – physical accessibility; organizational level – operation and infrastructure, team approach, training in behavioural health, electronic medical record, and staffing; and policy level – funds and health insurance. Most facilitating factors were on the organizational level and related to infrastructure, team approach, patient‐centered care, and the most noted barrier was poor relationships. Nurses can increase engagement in integrated care by assuming roles that oversee patient care, foster professional collaborations, and improve relationships. Future research should focus on vulnerable populations this model serves, patients' perspectives, and the effect of telehealth. [ABSTRACT FROM AUTHOR]

Objective: Adolescents' unintended pregnancy and sexually transmitted infections have a significant impact on the individuals themselves and on society. Peer leaders are students trained to become role models and leaders who promote positive behaviour change in their schools and community. A few studies have examined the effects of taking the role of peer leaders on the teenagers themselves including the long-term benefits. The aim of this study was to enhance understanding of the peer leader experience as it relates to peer leaders themselves and to explore the lasting impact of their experience. Design: The study used an exploratory qualitative design. Setting: Included peer leaders were employed by a non-profit organisation working with Southeastern Massachusetts communities with a high teenage pregnancy rate. Methods: Qualitative research included individual semi-structured interviews with 18 past and present peer leaders. Interviews were recorded and transcribed verbatim. Data were coded and analysed for common themes. Results: Being a peer leader was a life-changing experience. The benefits varied from learning reproductive health content to developing life skills, friendships and long-lasting career-related skills. Being a member of a peer leader group provided an instant support group and a new circle of friends as well as a purpose. It also removed peer leaders from health risk behaviours. Their experience assisting others in need was rewarding as well as being a confidence builder. Through community service, the peer leaders changed their perceptions about and towards the needs of the people residing in their community. Conclusion: This study demonstrated the value of incorporating peer leaders in sexual and reproductive health programmes. The peer leader programme examined was not only instrumental in providing education in sexual health but it also created change in the lives of the peer leaders themselves, their families and communities. [ABSTRACT FROM AUTHOR]

A mixed method approach explored teens' preferred source of information on sex and reproductive health. Parents' concerns about and perceived barriers to providing reproductive health information to their teens were also explored. Data were gathered from an online survey of 347 teens and three focus groups comprising parents of teens from three Massachusetts communities. Most teens expressed their desire for parents to be one of their primary sources of information (85%). Most parents believed that sexual education should start at home, yet many have not communicated such information. Parents expressed difficulty in staying up-to-date and felt uncomfortable communicating with their teens. Parent perception of supporting factors included a good parent-child relationship and beginning the discussions at a young age. There is a need for culturally sensitive and innovative interventions aimed at creating a safe place for parents to gain knowledge, resources, and strategies to talk to their teens about sex and reproductive health. [ABSTRACT FROM AUTHOR]

Attending a college or university opens a new chapter in a young man's life, and with it comes new experiences, freedoms, and responsibilities. Young adult males in particular are prone to risky behaviors as a result of peer pressure, and this can affect their health. As a result of this risky behavior, reproductive and sexual health could be compromised. Historically, reproductive health (RH) services have predominantly served women and undeserving men. Young men have significant reproductive health risks in the form of sexually transmitted infections (STI). Male sexual behaviors directly affect their female partners' health, and their shared decisions about reproductive health play an important part in preventing unintended pregnancies. The office of Population Affairs, Office of Family Planning (OFP), in partnership with five agencies and one research-coordinating center, has implemented a four-year comprehensive service delivery model to increase the number of males accessing family planning, reproductive health services. This paper describes the process of implementing male reproductive health services in a university clinic in western Massachusetts. The Service Innovation Model includes: 1) restructuring the clinic environment (physical setting, materials, and Internet presence), 2) staff training, and 3) campus outreach. [ABSTRACT FROM PUBLISHER]

Background and methodology Unintended pregnancy is a concern in the USA due to its association with adverse physical, mental, social and economic outcomes. Few studies have examined this issue among married women from a social and contextual perspective. This study targeted married women to examine factors associated with unintended pregnancy using the ecological model of health promotion that focuses attention on both individual and social environmental factors. Data from the National Survey of Family Growth (NSFG) were merged with NSFG contextual files to examine the major predictive factors. Results Multilevel logistic regression modelling revealed that married women of lower socioeconomic status, higher parity, who lived in communities with a high rate of marital dissolution had a higher probability of an unintended pregnancy. Women reported that their husbands were likely to concur with the unintended designation of the pregnancy. Discussion and conclusions This study utilised a unique perspective to examine contextual factors related to unintended pregnancy among married women. The results support the need to focus on the couple as a unit for prevention efforts. Social policies to enhance access to family planning services are necessary to improve outcomes and prevent unintended pregnancies. [ABSTRACT FROM PUBLISHER]

In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field. [ABSTRACT FROM AUTHOR]