Search

This study examined the psychometric equivalence of paper-and-pencil and Internet formats of key questionnaires used in couple research. Self-report questionnaires assessing interpersonal constructs (relationship satisfaction, communication/conflict management, partner support, emotional intimacy) and intrapersonal constructs (individual traits, psychological symptoms, contextual influences) were administered to young adults in committed dating relationships. The same measures were administered twice via paper-and-pencil and/or Internet methods over a 2-week period. Method order was counterbalanced among participants, and temporal stability was controlled. Intrapersonal and interpersonal measures generally remained reliable when administered online and demonstrated quantitative and qualitative equivalence across methods. The implications of online administration of questionnaires are discussed, and specific recommendations are made for researchers who wish to transition to online data collection. [ABSTRACT FROM PUBLISHER]

Purpose: The prevalence of Congolese refugee women seeking asylum in the USA has recently garnered substantial attention. Many women have fled the Democratic Republic of Congo due to trauma and loss. Likewise, the resettlement process, particularly acculturative stress, may exacerbate mental health issues such as depression and anxiety. By recognizing the centrality of family within Congolese culture, this study aims to investigate cultural beliefs about family among Congolese refugee women in the USA, using acculturative theory as an interpretative lens. Design/methodology/approach: The authors' study centered on understanding the resettlement experiences of 20 Congolese refugee women living within an urban area of Midwest America after their arrival in America since 2011. Through using convenient sampling methods, the authors chose these particular activists as they could provide insight into their stories concerning their journey from Congo to settling down as refugees within Northeast America. During interviews, semi-structured questioning was used to gather responses from participants which were later analyzed through implementing a thematic interpretation process. Findings: Three themes emerged encapsulating cultural beliefs about family: supporting one another; the importance of togetherness; and disciplining our children. These findings provide culturally tailored resources to support Congolese refugee women and their families upon resettlement optimally. Research limitations/implications: The authors' work provides health equity researchers with an opportunity to better understand cultural beliefs among Congolese refugee women. Findings from this study provide an increased understanding of how to provide culturally specific tools to better aid Congolese refugee women and their families upon arrival. Practical implications: The authors' research offers insights for health equity researchers seeking to understand the cultural beliefs of Congolese refugee women. The findings contribute to an enhanced understanding of how to provide culturally specific resources better to support Congolese refugee women and their families upon arrival. Originality/value: The authors verify that, to the best of the authors' knowledge, the paper was written completely independently, and neither the entire work nor any of its parts have been previously published. The authors confirm that the paper has not been submitted to peer review, nor is in the process of peer reviewing, nor has been accepted for publishing in another journal. The authors confirm that the research in their work is original. [ABSTRACT FROM AUTHOR]

As previous research has observed, medical students and physicians alike confront vast amounts of knowledge in their education and practice, such that no one clinician can know everything there is to know about biomedicine. Even before clerkships, medical students learn to cope with this impossibility by prioritizing certain information based on its perceived utility for exams and clinical practice. Many factors can shape this process, including teamwork, wherein individual medical students rely on one another to address gaps in knowledge at the level of the group. This paper will draw on qualitative data from two allopathic medical schools in the American Midwest to demonstrate that peer-to-peer learning, a widely utilized pedagogical modality in North American medical schools, is amongst the earliest places where future physicians learn how to rely on their peers in the profession as they make choices about what to know and what not to know about biomedicine: cultivating a culture of "intraprofessionalism" between students with different knowledges and values, as they prepare to enter the same profession. The paper will also consider how differences in the student populations at two field sites impact intraprofessional development. Drawing on scholarship of peer-based learning strategies and the sociology and anthropology of medical education, the authors argue that peer-to-peer learning is a key site in the professional socialization of medical students toward the effective management of medical knowledge. [ABSTRACT FROM AUTHOR]

Background: Treatment for partners of patients diagnosed with sexually transmitted infections (STI), referred to as expedited partner therapy (EPT), is infrequently used in the emergency department (ED). This was a pilot program to initiate and evaluate EPT through medication-in-hand ("take-home") kits or paper prescriptions. In this study we aimed to assess the frequency of EPT prescribing, the efficacy of a randomized best practice advisory (BPA) on the uptake, perceptions of emergency clinicians regarding the EPT pilot, and factors associated with EPT prescribing. Methods: We conducted this pilot study at an academic ED in the midwestern US between August-October 2021. The primary outcome of EPT prescription uptake and the BPA impact was measured via chart abstraction and analyzed through summary statistics and the Fisher exact test. We analyzed the secondary outcome of barriers and facilitators to program implementation through ED staff interviews (physicians, physician assistants, and nurses). We used a rapid qualitative assessment method for the analysis of the interviews. Results: During the study period, 52 ED patients were treated for chlamydia/gonorrhea, and EPT was offered to 25% (95% CI 15%-39%) of them. Expedited partner therapy was prescribed significantly more often (42% vs 8%; P < 0.01) when the interruptive pop-up alert BPA was shown compared to not shown. Barriers identified in the interviews included workflow constraints and knowledge of EPT availability. The BPA was viewed positively by the majority of participants. Conclusion: In this pilot EPT program, expedited partner therapy was provided to 25% of ED patients who appeared eligible to receive it. The interruptive pop-up alert BPA significantly increased EPT prescribing. Barriers identified to EPT prescribing should be the subject of future interventions to improve provision of EPT from the emergency department. [ABSTRACT FROM AUTHOR]

This study compared the reliability and validity of student scores from paper–pencil and e-based assessments using the "maze" and "silent reading fluency" (SRF) tasks. Forty students who were deaf and hard of hearing and reading between the second and fifth grade reading levels and their teachers (n  = 21) participated. For maze, alternate form reliability coefficients obtained from correct scores and correct scores adjusted for guessing ranged from r  = .61 to.84 (p s  <  .01); criterion-related validity coefficients ranged from r  = .33 to.67 (most p s < .01). For SRF, reliability coefficients obtained from correct scores ranged from r  = .50 to.75 (p s  <  .01); validity ranged from r  = .25 to.72. Differences between student performance on paper–pencil and e-based conditions were generally non-significant for maze; significant differences between conditions for SRF favored the paper–pencil condition. Findings suggest that maze holds promise, with inconclusive results for SRF. [ABSTRACT FROM AUTHOR]

BACKGROUND: We analyzed data from a study to evaluate the effectiveness of the Relationships Under Construction (RUC) sexual risk avoidance education program promoting positive youth development and healthy relationships. METHODS: Twelve schools in the Midwestern region of the United States randomized to the intervention implemented RUC in health or science classes, while control schools collected study measures and implemented the standard curriculum. RESULTS: Post‐randomization analyses revealed significant differences in grade, race/ethnicity, and prior relationship education at baseline between intervention and control students. Subsequent analyses controlled for these differences. We distributed parental notification letters to 641 students, and no parents requested that their adolescent opt out of data collection. We obtained assent and baseline computer‐assisted survey interviews or paper‐and‐pencil instrument forms from 100% of these students. Findings suggest that RUC significantly reduced sexual activity (odds ratio = 0.56, p =.046) at 3‐month follow‐up, compared to those in the control group. RUC also reduced pornography viewing and improved attitudes about delayed gratification, beliefs, decision making, and negative outcome expectations. CONCLUSIONS: Our findings suggest that RUC improves sexual attitudes, beliefs, and behaviors among this population of adolescents. Additional research is needed to assess RUC impacts among diverse populations. [ABSTRACT FROM AUTHOR]

Purpose: Although the scholarship of teaching and learning literature in the area of augmentative and alternative communication (AAC) continues to grow, there is a need for research focused on preservice speech-language pathologists' (SLPs') preparedness for practice and the roles related to AAC they will assume as professionals. The purpose of this study was to explore students' perceptions of learning outcomes and perceived preparedness for roles related to AAC service provision. Method: Forty master's level speech-language pathology students enrolled in two graduate-level AAC courses read about, discussed, and reflected on roles related to AAC at the beginning and end of the course. A mixed-methods approach was used to analyze and compare participants' (a) perceived level of preparedness, self-rated using a Likert scale; (b) reflections on preparedness at the beginning and end of the course; (c) learning priorities at the beginning of the course; and (d) perceptions of learning outcomes at the end of the course. Results: Overall, participants' perceived preparedness improved from the beginning to the end of the course for all roles. Improvements in ratings for the roles of general practice SLP, AAC finder, AAC facilitator/communication partner, and AAC clinical specialist were statistically significant. The data revealed what and how students wanted to learn and the impact of course learning activities on their professional identity development, particularly related to the roles they envision taking on as practicing professionals. Conclusions: The findings have direct implications for teaching and learning in AAC coursework and advancing preservice education in the area of AAC. This study adds to the literature by describing a low-stakes, efficient reflection task that has the potential to impact professional identity development among students and perhaps practitioners as well. [ABSTRACT FROM AUTHOR]

Background: While the effectiveness of tutoring‐style videos has been reported in previous studies conducted in laboratories, how these types of videos facilitate students' learning experiences and achievement has not been much explored in prior studies, which prevents discussion on how to design such tutoring‐style videos. Objectives: In this study, we addressed the limitations reported in studies conducted in authentic classes and attempted to explore students' learning patterns and experiences with tutoring‐style videos involving interactions between the instructor and agents. In addition, we attempted to reveal what instructional strategies can be used in tutoring‐style videos to enhance students' engagement and achievement. Methods: The study took place in an undergraduate introductory biology class offered at a university located in the Midwest of the United States. The same instructor taught two sections of this course which lasted for 15 weeks during a Spring semester. The two sections were randomly assigned to an experimental group in which participants watched tutoring‐style videos and a control group with participants watching traditional videos. The experiment was administered in a module lasting two and a half weeks focused on microbiology. Surveys and tests were conducted to determine whether the tutoring‐style videos had a positive impact on student engagement and achievement. In addition, a video content analysis was carried out to elicit insights on how to design effective tutoring‐style videos. Results: For students' emotional engagement and perceived usefulness, no significant difference was found between the two groups, even though the descriptive statistics indicated slightly higher scores from the experimental group than the control group on both subscales. In terms of achievement, the participants reported significantly more learned concepts from watching rich‐interactions in the tutoring‐style videos than the participants in the control group; and they also reported a significantly smaller number of learned concepts from watching one‐interactions in the videos than the control group participants. We also found that instruction in the tutoring‐style videos used effective strategies for facilitating students' participation and cognitive processing. Conclusions: Our findings indicate that tutoring‐style videos can be effective learning materials by allowing students to engage in interactions between instructors and agents in the videos. The more instructional strategies used to facilitate the interactions between the instructor and the agents, the higher engagement can be expected from viewers. Our study would inform the design and development of effective tutoring‐style videos. Lay Description: What is already known about this topic: One‐on‐one tutoring is the gold standard in teaching.Tutoring‐style videos are found to be effective in teaching as well. What this paper adds: Tutoring‐style videos that film rich interactions lead to better learning.Tutoring‐style videos that film limited interactions are ineffective.Students who see agents in tutoring‐style videos as helpful perform better. Implications for practice and/or policy: Tutoring‐style videos should film rich interactions of tutoring sessions.Strategies should be used in videos to facilitate perceived agents' usefulness.Tutoring sessions filmed in videos should encourage a participatory atmosphere. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the implementation of evidence‐based, individualized coping plans and to compare the rates of child anxiety, child cooperation, and parent anxiety before and after implementation of these coping plans for children receiving recurring BoNT‐A injections emphasizing the role of Certified Child Life Specialists (CCLSs) within the interdisciplinary team approach. Design and Methods: A retrospective chart review was conducted for children receiving BoNT‐A injections at a Physical Medicine clinic pre‐ and post‐implementation of the coping plan. Descriptive statistics were used to evaluate care plan implementation, child cooperation, child anxiety, and parent anxiety. Results: Post‐implementation of coping care plans, children experienced improved cooperation during BoNT‐A injections. Parental anxiety decreased once coping plans were implemented. Documentation improved after the implementation of coping plans specific to areas involving cooperation, child's anxiety and distress, and parental anxiety and distress. It was also noted that there was an increase in child anxiety assessments within documentation. Practice Implications: CCLS were able to utilize their expertise to collaboratively create individualized coping care plans to increase child's cooperation and decrease parental anxiety during BoNT‐A injections. [ABSTRACT FROM AUTHOR]

Purpose: Self-efficacy is important for managing chronic conditions; however, its measurement in pediatric healthcare settings remains rare. The goal of this project was to adapt an existing disease-agnostic adult self-efficacy patient reported outcome (PRO) measure to enhance suitability of items for measuring the self-efficacy of parents that manage their children's health conditions. Methods: We adapted the existing Patient-Reported Outcomes Measurement Information System® (PROMIS®) adult self-efficacy healthcare measure to parental voice. First, a targeted literature review informed rephrasing of the adult items and identification of new pediatric-specific content. The initial item pool was revised based on input from 12 multidisciplinary experts. Next cognitive interviews of adapted items were simultaneously conducted with English and Spanish-speaking parents of pediatric patients with a range of chronic and/or disabling conditions recruited from a Midwestern children's hospital to finalize the measure. Results: Findings resulted in an initial item pool of 33 pediatric-specific items which were narrowed to 31 draft items based on expert input. Parent cognitive interview findings (N = 26) informed further item reduction resulting in a final measure consisting of 30 items representing nine domains. Fourteen items are relevant to children regardless of condition severity (e.g., health care information/decision making; symptom identification/management) and 16 items are relevant to children with specific health care needs (e.g., medication usage, equipment). Conclusion: We conducted a first step in developing a condition-agnostic, PRO measure of parental self-efficacy managing their children's chronic and/or disabling conditions that is acceptable and understandable to English and Spanish-speaking parents. Plain English Summary: Self-efficacy, which is someone's confidence in completing a task, is important for managing a chronic health condition. Knowing parents' self-efficacy managing their children's health conditions may be an important step in supporting their children's health but no single measure is available for diverse sets of conditions. In this paper, we present the development of a new patient reported outcomes measure designed to assess self-efficacy of parents managing their child's chronic and/or disabling conditions. We found that the measure is both acceptable and understandable to English and Spanish speakers and may be useful to proactively identify parents in need of additional supports at hospital discharge or at the time of a new diagnosis. [ABSTRACT FROM AUTHOR]

This paper first explores spatial distributions and patterns of COVID-19 case rates (cases/100,000 people) and mortality rates (deaths/100,000 people) and their disparities between urban and rural counties in the contiguous US. A county-level social vulnerability index was created using principal component analysis. Social vulnerability components were regressed against both county case and mortality rates. Results suggest that hotspots of case and mortality rates are clustered in Midwest and Upper-Midwest US. We found substantial disparities in case and mortality rates between urban and rural counties. County social vulnerability was positively correlated with both case and mortality rates suggesting counties with higher social vulnerability had higher case and mortality rates. Relationships between social vulnerability components and case and mortality rates vary across the conterminous US. Additionally, counties with increased racial and ethnic minorities, higher percentages of minors, and lower median household income are associated with higher COVID-19 case and mortality rates. [ABSTRACT FROM AUTHOR]

College students have high rates of post-traumatic stress disorder (PTSD) symptoms as well as high rates of sexual assault. What is less clear, however, is whether different sexual assault types (e.g. coercive, physically forced, and incapacitation) are associated with greater PTSD symptoms. Moreover, understanding early familial and mental health histories of college students is important for explaining PTSD symptoms. As such, we use a social stress framework to examine the relationships between early familial risk (i.e. child abuse, perceived maternal rejection), borderline personality (BP) symptoms, and three sexual assault types with PTSD symptoms among college students. A total of 783 undergraduate students (65.4% female) completed paper and pencil surveys in fall 2019 and spring 2020 at a large public university. Results revealed that females were more likely to experience child sexual abuse and all three forms of sexual assault, while males experienced higher rates of child physical abuse. OLS regression results showed positive associations between child sexual abuse, perceived maternal rejection, BP symptoms and all three types of sexual assault with PTSD symptoms. Females also experienced more PTSD symptoms compared to males. Findings have implications for targeted interventions to improve mental health outcomes. [ABSTRACT FROM AUTHOR]

Delirium is a serious complication of pediatric critical illness. Sleep disruption is frequently observed in children with delirium, and circadian rhythm dysregulation is one proposed cause of delirium. Children admitted to the pediatric intensive care unit (PICU) experience multiple environmental exposures with the potential to disrupt sleep. Although researchers have measured PICU light and sound exposure, sleep, and delirium, these variables have not yet been fully explored in a single study. Furthermore, caregiving patterns have not often been included as a component of the PICU environment. Measuring the light and sound exposure, caregiving patterns, and sleep of critically ill children requires continuous PICU bedside data collection. This presents multiple methodological challenges. In this paper, we describe the protocol for an observational pilot study of the PICU environment, sleep, and delirium experienced by a sample of 10 critically ill children 1–4 years of age. We also evaluate and discuss the feasibility (i.e., acceptability, implementation, practicality) of the study protocol. Light and sound exposure were measured with bedside sensors. Caregiving was quantified through video recording. Sleep was measured via actigraphy and confirmed by video recording. Delirium screening with the Cornell Assessment of Pediatric Delirium was conducted twice daily, either in person or via video review. This study provides a refined measurement framework to inform future, large‐scale studies and the development of nurse‐driven sleep promotion interventions. [ABSTRACT FROM AUTHOR]

The older adult population in the US is burgeoning and nurses will be at the forefront of providing the skilled, compassionate care needed for them. Undergraduate nursing students do not commonly desire to work with older adults after graduation, likely related to negative attitudes, which can adversely impact the care provided. To determine the effect of a course using a suite of teaching techniques designed to positively shift nursing students' attitudes toward older adults. A one group pre and post-test design was used to test the effect of completion of the Nursing Care of the Older Adult course on baccalaureate undergraduate junior level nursing students' attitudes toward older people at a large University in the Midwest for two consecutive years (2019 and 2020). A quality assurance evaluation using a voluntary anonymous survey (Kogan's Attitude Toward Older People Instrument) on paper (2019) or online (2020) took place on the first and last day of class. Normality was assessed and the central limit theorem was applicable, therefore, independent samples t-tests were performed on the primary outcome, total score, with the primary predictor as pre vs post. This process was repeated on a 2020 cohort in the same course with a paired samples t-test, as paired subject ID's were recorded in 2020 but not in 2019. Due to the impact of the COVID-19 pandemic on all parts of academic life, no direct comparisons were made between the 2019 and 2020 samples. Course content included lectures, videos, MaskEd™ simulation, group work, case studies and clinical experiences. Both cohorts had significant improvement in the total Kogan instrument score, indicating a positive change in attitudes toward older adults [2019 pre M 167.2, SD 20.3 to post M 176.9, SD 22.4, t (292.43) = 3.96, p < 0.001 and 2020 pre M 179.4, SD 21.3 to post M 188.1, SD 22.2, t (70) = −5.61, p < 0.001]. The innovative, intentional teaching strategies incorporated into this gerontology course were effective in promoting positive attitudes toward older adults. [ABSTRACT FROM AUTHOR]

Family Team Conference (FTC) has been suggested as a promising practice model to improve child welfare outcomes. However, there is little understanding of developing an effective workforce to ensure FTC fidelity. Using data involving 891 caseworkers who implemented FTC in a Midwestern state, path analysis showed that both effective training and supervision that parallels the same principles of FTC are necessary conditions to enhance FTC fidelity either directly or indirectly by increasing caseworkers' facilitation skills. This paper suggests that organizational readiness and ongoing support are essential for ensuring the high-quality implementation of family-centered practice in the public child welfare system. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner violence (IPV) and substance use disorder (SUD) frequently co-occur and are rarely addressed together despite evidence indicating benefits of combined interventions. Both are linked to trauma. Scholars have theorized attention to trauma may facilitate engagement with IPV and SUD but have not studied this potential empirically. Methods: Using service system level quantitative data on organizations focused on IPV or SUD (n = 281) in a midwestern city in the United States and semi-structured interviews with policymakers, funders, and practitioners in both areas (n = 27), this paper uses grounded theory to explore whether attention to trauma facilitates attention to IPV and SUD. Results: While quantitative data suggest addressing trauma and both IPV and SUD are associated at the service system level, analysis of interview data indicates greater complexity. Despite consensus on trauma-informed care's potential, competing understandings of temporality (when trauma occurs in relation to IPV or SUD), different liabilities associated with addressing trauma, and different intervention approaches combine to limit engagement by both IPV and SUD organizations. Rather than adopting trauma-informed care, both types of organizations more typically engage trauma selectively, offering discrete services rather than holistic intervention. Findings have implications for addressing co-occurring IPV, SUD, and trauma and for practice, policy, education, and research. Conclusions: There is need for greater consensus about what it means to address trauma, increased investments in practitioner education and training around intersections of IPV, SUD, and trauma, and additional supports to incentivize movement from a trauma services approach towards meaningful implementation of trauma-informed care. [ABSTRACT FROM AUTHOR]

Prior studies have focused on general technology use and technology use in domain‐general applications and quantity of technology use. Recent evidence suggests that investigations should consider how technology is used in more contextually specific ways, including how technology is used for various cognitive tasks in specific classrooms. The purpose of this study was to examine the ways in which classroom content area and student goal orientation have a coordinated influence for how students used technology to support learning. The sample included high school students in a Midwestern state who were surveyed on their motivation and how they used technology to support learning. The study employed hierarchical linear modelling to examine how goal orientation and classroom content area predicted various levels of Bloom's Digital Taxonomy. Students who adopted mastery‐oriented goals were more likely to use technology for various cognitive tasks, especially those at higher levels of complexity. Lastly, the association between mastery goal orientation and some aspects of technology use was conditioned on content area, although effect sizes were small. This study showed that, overall, technology is used differentially across four core content areas. Students in mathematics classrooms used technology less, however much of technology use was evident at lower cognitive levels. Second, students' goal orientation, and in particular their mastery goals influence how technology is used across content areas, and this is marginally conditioned on content area. Technology use should match the instructional context to maximize technology use and students' goal orientation. Lay Description: What is already known about this topic: Computer technology tools support cognitive engagementTechnology tool availability differs by content areaStudent motivation is often positively related to increased technology use What this paper adds: Student technology use for various cognitive tasks differed by content areaStudents with mastery goals were more likely to use technology differentlyMotivational patterns' effect on technology use did not differ by content areaStudents in math used technology qualitatively less than other content areas Implications for practice and/or policy: Greater emphasis should be placed on choosing technology to match content areasTechnology should be appropriately chosen to maximize cognitive learning tasksTo support technology use, teachers should help student mastery learning goals [ABSTRACT FROM AUTHOR]

The current paper evaluates a pilot program implementing Trust-Based Relational Intervention (TBRI) among a sample of child welfare staff working across eight organizations in order to (1) describe the first year of implementation and (2) examine staff and organizational change. Staff completed assessments of trauma-informed care attitudes and organizational functioning at the start of the project and at the end of the first year of implementation. Results indicate improvement across scales, with implications for the importance of fostering key roles (e.g., mentors) and planning for workforce changes (e.g., recurring trainings) in facilitating implementations that will function in child welfare settings. [ABSTRACT FROM AUTHOR]

Leaders in nursing education embrace innovative, real‐world learning environments that transform today's generation of nursing students into critical thinkers. Scheduling exclusive child‐bearing practicums are challenging due to staffing, time, and maternal client presentation. Utilizing transformative learning theory a perinatal continuum of care clinical learning experience evolved. This paper will discuss the qualitative, descriptive study of Bachelor of Science in Nursing students in rural, Midwestern United States who completed maternal/infant didactic, high‐fidelity simulation, and real‐world experiences relative to women during the perinatal period. Participants (n = 50) consisted of third‐semester baccalaureate nursing students enrolled in the maternal/infant course. Data were collected from students' reflective journal blogs at the end of the semester. The aim of this study was to identify the outcomes of students learning through this perinatal experience. Three themes emerged from this study: self‐analysis, critical thinking, and self‐efficacy. Students' reflection indicated that through this comprehensive clinical experience, they developed a new self‐awareness. Students noted that the experience was unique to any they had encountered. The perinatal assignment provided an opportunity for professional growth in this specialty area due to the interface of theory, simulation, and clinical applications expounded in the reflective clinical blog throughout the experience. [ABSTRACT FROM AUTHOR]

Objectives: Expectant and parenting students (EPS) at community colleges are an underserved and often under-resourced group. In a rural, Midwestern state, the department of public health was awarded the Pregnancy Assistance Fund (PAF) grant to assist this population. This paper outlines the results of the implementation evaluation and offers suggestions for programs and evaluators working with this population in the community college setting. Methods: We conducted a multicomponent evaluation utilizing quantitative and qualitative methods. Evaluation activities included tracking activities/services, surveys and interviews with participants, and interviews with community college staff implementing grant activities. The research team calculated frequencies for quantitative data and coded qualitative data for themes. Results: Data from the community colleges and students' self-reports revealed that EPS most commonly received concrete support from the program, often in the form of stipends or gift cards. Students reported that concrete support was beneficial and helped to relieve financial stress during the semester. Students' major barriers to participation were lack of knowledge about the program and busy schedules that prevented them from accessing PAF services. Staff reported that difficulty identifying EPS and the short one-year project period were major implementation challenges. Conclusions for Practice: We recommend that community colleges work to identify EPS, use fellow EPS to recruit program participants, and implement programming that works with the students' schedules. [ABSTRACT FROM AUTHOR]

Objective: Identify determinants of emergency medical service (EMS) personnel's willingness to work during an influenza pandemic. Background: Little is known about the willingness of EMS personnel to work during a future influenza pandemic or the extent to which they are receiving pandemic training. Methods: EMS personnel were surveyed in July 2018 – Feb 2019 using a cross-sectional approach; the survey was available both electronically and on paper. Participants were provided a pandemic scenario and asked about their willingness to respond if requested or required; additional questions assessed their attitudes and beliefs and training received. Chi-square tests assessed differences in attitude/belief questions by willingness to work. Logistic regressions were used to identify significant predictors of response willingness when requested or required, controlling for gender and race. Results: 433 individuals completed the survey (response rate = 82.9%). A quarter (26.8%, n = 116) received no pandemic training; 14.3% (n = 62) participated in a pandemic exercise. Significantly more EMS personnel were willing to work when required versus when only requested (88.2% vs 76.9%, X2 = 164.1, p <.001). Predictors of willingness to work when requested included believing it is their responsibility to work, believing their coworkers were likely to work, receiving prophylaxis for themselves and their family members, and feeling safe working during a pandemic. Discussion: Many emergency medical services personnel report lacking training or disaster exercises related to influenza pandemics, and a fair percentage are unwilling to work during a future event. This may limit healthcare surge capacity and could contribute to increased morbidity and mortality. Findings from this study indicate that prehospital staff's attitudes and beliefs about pandemics influence their willingness to work. Pre-event training and planning should address these concerns. [ABSTRACT FROM AUTHOR]

In this paper, we examined diet quality and associations between changes in skin carotenoids and body composition among selected NCAA Division I athletes. Methods: Athletes from women’s (rowing, swimming, gymnastics) and men’s (swimming, wrestling) teams at a large Midwest university (N = 129) completed one online food frequency questionnaire and 2 in-person visits, once in-season and once out-of-season, to assess skin carotenoids and body composition. Diet quality was assessed via Healthy Eating Index-2015 (HEI). Carotenoids were measured via resonance Raman spectroscopy and body composition via dual-energy x-ray absorptiometry. ANOVA and Pearson correlations were used to test differences between teams and determine association between changes from in-season to out-of-season. Results: Mean HEI score for all athletes was 71.0. Women’s rowing reported the highest diet quality (73.5), men’s wrestling lowest (56.5). Skin carotenoids decreased for all teams, except men’s wrestling, from in-season to out-of-season. Body fat percentage increased for women and decreased for men. There was a moderate inverse association between changes in skin carotenoids and body fat percentage (r = -.334, p = .001). Conclusions: Suboptimal diet quality coupled with decreases in skin carotenoids and increases in body fat percentage from in-season to out-of-season may justify dietitian-led interventions year-round to improve dietary patterns in collegiate athletes [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess physician assistant students' knowledge about the screening, transmission, management, and prevention of Zika virus infection. Background: It is important for health care providers in the United States to recognize the symptoms of Zika so that they can screen, diagnose, and or treat persons exposed to or infected by the virus. Physician assistant students, on completion of their educational program and passing their board examinations, provide care for patients in primary care or specialty settings where they may treat patients who either have the virus or post-virus exposure. Methods: A convenience sample of 37 students enrolled in a physician assistant studies program in the Midwestern United States completed an in-person self-administered paper-and-pencil questionnaire that tested their knowledge about Zika virus infection. Results: All the respondents knew that the disease is of viral origin; however, only 89% knew that mosquitoes were the natural host. Primary modes of transmission were identified as sexual contact and blood transfusion (47% and 44% of respondents respectively); 47% incorrectly identified amniotic fluid as a transmission mode. More than half (61%) knew that health care providers should ask pregnant women about any possible virus exposure before and during pregnancy at each prenatal visit. Most respondents knew that muscle/joint pain (67%) was one of the symptoms of Zika infection, but only 39%, 25%, and 19% also identified low-grade fever, maculopapular rash, and conjunctivitis respectively as other symptoms. Some participants incorrectly identified antivirals (44%) and nonsteroidal anti-inflammatory medications (36%) rather than the recommended treatments of pain relief (30%) and fever relief (42%) medications for clinical management of the disease. [ABSTRACT FROM AUTHOR]

Background/Objectives: The primary objective of this research was to assess age differences in the associations between cyberbullying victimization and bystanding and depression among 234 elementary school students (4th and 5th graders; 51% female), 363 middle school students (6th to 8th grades; 53% female), and 341 high school students (9th to 12th grades; 51% female) as well as the moderating effect of parental mediation in these relationships. Methods: Participants completed self-report questionnaires on their cyberbullying victimization and bystanding, as well as depressive symptoms. Results: The findings revealed that high levels of instructive mediation buffered against depression associated with cyberbullying victimization and bystanding across all age groups, with the strongest effects found for middle school students. Lower levels of instructive mediation and higher levels of restrictive mediation increased the positive relationships between cyberbullying victimization and bystanding and depression. Co-viewing mediation did not moderate any of the associations. Conclusions: Parental mediation of technology use has the potential to alleviate the negative consequences associated with cyberbullying victimization and bystanding. The findings highlight the importance of tailoring prevention and intervention strategies to specific age groups and to parents. [ABSTRACT FROM AUTHOR]

Introduction: As opioid overdose deaths continue to rise, the emergency department (ED) remains an important point of contact for many at risk for overdose. In this study our purpose was to better understand the attitudes, beliefs, and knowledge of ED nurses in caring for patients with opioid use disorder (OUD). We hypothesized a difference in training received and attitudes toward caring for patients with OUD between nurses with <5 years and ≥6 years of clinical experience. Methods: We conducted a survey among ED nurses in a large academic medical center from May-July 2022. All ED staff nurses were surveyed. Data entry instruments for the nursing surveys were programmed in Qualtrics, and we analyzed results R using a chi-square test or Fisher exact test to compare nurses with <5 years and ≥6 years of clinical experience. A P-value of < 0.05 was considered statistically significant. Results: We distributed 74 surveys, and 69 were completed (93%). Attitudes toward naloxone distribution from the ED were positive, with 72% of respondents reporting they were “very” or “extremely” supportive of distributing naloxone kits to individuals at risk of overdose. While attitudes were positive, barriers included limited time, lack of system support, and cost. Level of comfort in caring for patients with OUD was high, with 78% of respondents “very” or “extremely” comfortable. More education is needed on overdose education and naloxone distribution (OEND) with respondents 38% and 45% “a little” or “somewhat” comfortable, respectively. Nurses with <5 years of experience reported receiving more training on OEND in nursing school compared to those with ≥6 years of experience (P = 0.03). There were no significant differences in reported attitudes, knowledge, or comfort in caring for patients with OUD. Conclusion: In this single-center survey, we found ED nurses were supportive of overdose education and naloxone distribution. There are opportunities for targeted education and addressing systemic barriers to OEND. All interventions should be evaluated to gauge impact on knowledge, attitudes, and behaviors. [ABSTRACT FROM AUTHOR]

A short survey was conducted in 2019 to determine knowledge of bioactive forages for parasite control, including specifically Sericea Lespedeza (Lespedeza cuneata), before or during small ruminant workshops (also available online via SurveyMonkey® - link sent to a small ruminant email list). Questions also included livestock owned, hay grown and/or fed, and interest in bioactive forages, among others. Descriptive statistics were obtained by using weighted (by region for goat numbers) SURVEYMEANS procedures (SAS). A total of 151 surveys were completed, including paper (n = 45) and online responses (n = 106). Response rate for paper surveys was 90%. Twenty-six of the fifty states were represented and assigned to regions: Southeast (SE), Midwest (MW), Northeast (NE), and southwestern and western combined (SWW). The highest responses came from the SE (unweighted), but after weighting, the SWW region was represented at the highest level (P < 0.001). Nearly 100% of respondents had small ruminants on their farm, most fed both grass and legume hay (P < 0.001), 36.5 ± 8.6% raised hay, but very few sold hay (4.9 ± 1.5%; less than those that did not, P < 0.001). The most popular method of marketing for hay was "word of mouth" (P < 0.001). Prior knowledge of forage plants with bioactivity was noted for 78.0 ± 8.1% (P < 0.001) vs those without. Approximately a third of respondents had used or grown sericea lespedeza (32.8 ± 8.4%; P < 0.05) and most (tendency, P < 0.07) thought of it favorably. Almost half of respondents indicated they were willing to grow sericea lespedeza (P < 0.02). Other sericea lespedeza products of interest to respondents included primarily pellets (around 85.3 ± 8.3%), with little interest in silage (2.2 ± 1.1%; P < 0.0001). Producer surveys, such as this, help inform efforts for researchers and Extension staff. [ABSTRACT FROM AUTHOR]

Virtual learning environments can now be enriched not only with visual and auditory information, but also with tactile and kinesthetic feedback. However, the way to successfully integrate haptic feedback on a multimodal learning environment is still unclear. This study aims to provide guidelines on how visuohaptic simulations can be implemented effectively, thus the research question is: Under what conditions do visual and tactile information support students' development of conceptual learning of force‐related concepts? Participants comprised 170 undergraduate students of a Midwestern University enrolled in a physics for elementary education class. Four experiments were conducted using four different configurations of multimodal learning environments: Visual feedback only, haptic force feedback only, visual and haptic force feedback at the same time, and sequenced modality of haptic feedback first and visual feedback second. Our results suggest that haptic force feedback has the potential to enrich learning when compared with visual only environments. Also, haptic and visual modalities interact better when sequenced one after another rather than presented simultaneously. Finally, exposure to virtual learning environments enhanced by haptic forced feedback was a positive experience, but the ease of use and ease of interpretation was not so evident. Lay Description: What is already known about the topic: Multimedia learning environments enrich learning by using verbal and non‐verbal modalities.Previous research about the impact of haptic feedback in the simulation of abstract phenomena has not provided concluding results.It has been hypothesized that exposure to diverse stimuli at the same time may cause cognitive overload.What this paper adds: Sequenced modality of haptic force feedback first and visual feedback second may provide a learning advantage to single modalities or combined modalities.Participants' interaction with haptic force feedback was perceived as a positive learning experience.Implications for practice and/or policy: Participants exposed to any haptic force feedback stimulus outperformed participants interacting with visual feedback only. However, the difference was not statistically different at ∝ = 0.05.The incorporation of haptic force feedback to a multimodal learning environment may improve students' performance when delivered via a sequenced approach. [ABSTRACT FROM AUTHOR]

The increasing number of immigrants entering the United States suggests the need for more scholarly work aimed at identifying and addressing the healthcare needs of this population. This paper examines the physical, spiritual, environmental, intellectual, social, vocational and emotional health domains of a sample of adult immigrants in the mid-west US. The paper also looks at their reported home remedies from their countries. Both qualitative and basic quantitative tools were utilized to examine participants' subjective health status in the eight-dimensions of health and the kinds of home remedies they reported that they brought to the US. A thematic analysis was used to examine the qualitative data and basic descriptive statistics such as frequencies and percentages were computed. Overall, the majority of the immigrants in this study reported significant positive improvements in their overall health except for environmental health since moving to the US. We also learned from participants that they brought food and drink remedies, traditional medications, herbal medicine, over the counter medicine from home, homeopathy, Shi a tsu (massage), exercise (martial arts) to the US to treat their illnesses. Future research should better define and address these environmental health concerns and their impact on the overall health of the immigrants. [ABSTRACT FROM AUTHOR]

Considering the increasingly challenging resource environments in many business schools, this study examined whether course technologies, learner behaviors or instructor behaviors best predict online course outcomes so that administrators and support personnel can prioritize their efforts and investments. Based on reviewing prior online and blended management education literature, we hypothesized that instructor behaviors would be most predictive of online course outcomes. However, our study of 48 online Master of Business Administration courses found that although instructor behaviors (operationalized as teaching presence) was the strongest predictor of any of our three outcome variables (perceived learning), only student behaviors (operationalized as social presence) significantly predicted all three (course grades, perceived learning and delivery medium satisfaction). Technological characteristics, operationalized using variables from the technology acceptance model and media variety, predicted perceived learning (perceived ease of use) and delivery medium satisfaction (perceived usefulness). The paper provides recommendations for instructors and administrators based on the findings, specifically advocating for a balance between instructor and administrator involvement in course design, presentation and conduct. The paper concludes by describing research opportunities regarding the roles of social presence in and collaborative approaches to online learning in business schools. [ABSTRACT FROM AUTHOR]

School-based universal screening in the social, emotional, and behavioral (SEB) domains allows for the early identification of students in need of SEB support. Importantly, equitable assessment in universal screening for the SEB domains is critical to engage in accurate and ethical data-based decision-making. Measurement invariance is one method for examining potential inequities in assessment tools, permitting the ability to evaluate which assessments or assessment items perform differently across groups. As such, this study utilized multi-group confirmatory factor analysis to evaluate the extent of measurement invariance for a commonly used universal screening tool for the SEB domains: the Social, Academic, and Emotional Behavior Risk Screener - Teacher Rating Scale (SAEBRS-TRS). The sample consisted of 1949 students in kindergarten through fourth grade in a Midwest, suburban school district. Examination of factor structures indicated the bifactor model yielded adequate fit and was utilized for measurement invariance testing. Multi-group confirmatory factor analysis results provided preliminary evidence that the SAEBRS-TRS displays invariance across a variety of student characteristics. Specifically, results supported configural and metric/scalar invariance of the bifactor model across the student characteristics of racial or ethnic identity, sex assigned at birth, and eligibility for free or reduced-price lunch. Yet, future research is needed to corroborate these findings. Limitations, implications for practice, and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Two risk factors for negative outcomes in Latina/o youth are acculturation dissonance (i.e., discrepant family cultural orientations) and the endorsement of an assimilation strategy of acculturation (i.e., valuing dominant mainstream culture over culture of origin). Though these have been uniquely studied as risk factors for maladaptive behaviors among Latina/o youth, their interaction in relation to both externalizing and internalizing symptoms has yet to be fully examined. Objective: The present study examined the unique and interactive effects of acculturation dissonance and assimilation on both depressive symptoms and delinquent behaviors among Latina/o adolescents. Methods: Participants were 135 Latina/o adolescents (ages 14-20) recruited from a charter high school. Students responded to a paper-and-pencil survey assessing demographic information, acculturation strategy, acculturation dissonance, depressive symptoms, and delinquency. Results: Acculturation dissonance was uniquely associated with depressive symptoms, but interaction effects suggested this association depended on levels of assimilation. At high levels of assimilation, acculturation dissonance was not associated with depressive symptoms, since depressive symptoms were consistently high. In contrast, at low levels of assimilation, acculturation dissonance was positively associated with depressive symptoms. In contrast, acculturation dissonance was uniquely associated with delinquency, and this association did not depend on the level of assimilation. Conclusions: Dissonant cultural orientations within families of Latina/o youth confer risk for negative outcomes across internalizing and externalizing domains. For youth adopting an assimilation strategy of acculturation, risk for depressive symptoms may be increased. Implications of these findings and future directions are discussed. [ABSTRACT FROM AUTHOR]

It is well established that parental knowledge contributes to adolescents' well-being and school success and scholars have noted that parents and adolescents report different levels of knowledge. Discrepancies in parental knowledge have implications for adolescent outcomes such as risk behaviors, but little is known about the implications of knowledge discrepancies for adolescents' school outcomes. The present study examined discrepancies in parent and adolescent reports of parental knowledge and investigated the extent to which knowledge discrepancies were linked to school engagement. Participants were early adolescents ( N = 174; 53 % female) and their parents (90 % mothers). Adolescents (57 % African American/Black, 18 % multiracial, 17 % White/Caucasian, 7 % Hispanic/Latino and 1 % Asian American) attended a Midwestern, Title 1, urban, public middle school. Adolescents completed surveys in their homerooms and parents completed paper-pencil surveys at home or surveys via telephone. Results showed that parents reported more knowledge of adolescents' activities and whereabouts compared to adolescents' reports. Knowledge discrepancies were associated with school bonding and school self-esteem such that dyads in which adolescents reported more knowledge than their parents reported had significantly higher levels of school bonding and school self-esteem compared to dyads in which parents reported much more knowledge. [ABSTRACT FROM AUTHOR]

Purpose: Mental health providers are well-positioned to engage in suicide prevention efforts, yet implementation depends on skill acquisition and providers often report feeling underprepared. This pilot study explored the acceptability, feasibility, and preliminary effectiveness of three suicide prevention-focused simulations with virtual clients. Method: Students (n = 22) were recruited from a Master of Social Work program, completed pre- and post-test surveys, and engaged with three simulated trainings: (1) suicide risk assessment, (2) safety planning, and (3) motivating a client to treatment. Results: Simulations were reported to be acceptable and feasible, with strong student desire and need for greater suicide prevention training. We observed significant improvements over time in clinical skills via simulated training scores and perceptions of clinical preparedness. Discussion: Preliminary findings indicate simulated training with virtual clients is promising and suggest the three suicide prevention simulations may be useful, scalable, and effective in social work training programs and beyond. [ABSTRACT FROM AUTHOR]

Refugees and immigrants have experienced heightened health inequities related to COVID-19. As community-embedded frontline health personnel, refugee and immigrant community health workers (riCHWs) played essential roles in the provision of informational, instrumental, and emotional support during the unprecedented first year of the pandemic. Despite the importance of this workforce, riCHWs are at high risk for burnout due to low recognition and demanding workloads. This was exacerbated as riCHWs navigated a new and uncertain health delivery landscape. We sought to glean insight into riCHWs' stressors, coping strategies and resources, and self-efficacy to identify ways to support their work and wellbeing. Using a narrative inquiry approach, we conducted semi-structured, in-depth interviews with 11 riCHWs working in a midsized city in the midwestern United States. We generated three distinct yet interrelated themes: (1) Rapid and trustworthy information is key, (2) Creativity and perseverance are good ... structural support is better, and (3) Integrating riCHW expertise into health promotion programming and decision-making. Although riCHWs were deeply committed to enhancing community wellbeing, quickly shifting responsibilities in tandem with structural-level health inequities diminished their self-efficacy and mental health. riCHWs relied on work-based friends/colleagues for informational and emotional support to enhance their capacity to deliver services. Findings suggest increasing opportunities for peer support and idea-exchange, professional development, and integration of riCHW expertise in health promotion decision-making are effective strategies to enhance riCHWs' professional self-efficacy and personal wellbeing. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic in the United States, healthcare workers were devastated by the insufficient preparedness to respond to their patients' and personal health needs. A gap exists in resources to prevent or reduce acute and long-term healthcare worker mental illnesses resulting from COVID-19 frontline response. Methods: We performed an exploratory, mixed methods, longitudinal study of healthcare workers at a regional rural-urban hospital system in the Midwest United States during the COVID-19 response (4 timepoints, 2020). Using the Total Worker Health® (TWH) participatory needs assessment approach, self-identified frontline COVID-19 workers participated in a survey including Health-Related Quality of Life, Impact of Event Scale, and a modified version of the American Nursing Association COVID-19 survey; and a hospital timeline tracked system-level activities. Findings: Response rate at Timepoint (T)1 was 21.7% (N = 39) and of those, 14 (36%) completed all four surveys. From T1 to T4, the rate of COVID-19 patients steadily increased, staff exceeded the threshold for post-traumatic stress disorder at T1 and T4; staff reported not enough rest or sleep 50% of the month, T1-T4. Helpfulness of family support increased but community support decreased, T1-T4. Concerns with performing new tasks increased; the challenges related to lack of protective equipment and negative media decreased. Workers wanted to be involved in decision-making, desired timely communication, and needed adequate physical, environmental, and psychological supports. Conclusions/Applications for Practice: Utilization of a TWH® strategy for describing health needs, hospital response, and multi-level staff suggestions to workplace health solutions during the COVID-19 pandemic identified evidence-based health promotion interventions in a hospital system. [ABSTRACT FROM AUTHOR]

Objective: A campus-wide assessment examined the physical and mental health status of a midsize midwestern public university. Participants: Two thousand and forty-nine students, faculty, and staff on a single college campus were assessed in March–April 2013. Methods: Participants completed an online survey with sections devoted to demographics, physical and mental health status, and suicide knowledge and experiences. Results: This study captured broad physical and mental health indicators. Students, faculty, and staff in certain demographic groups were more likely to report significant problems associated with mental and physical health. Specifically, women, faculty and staff of color, and nonheterosexual persons reported worse health outcomes. Across 8 mental health indicators, students reported consistently worse mental health than their faculty/staff counterparts. Conclusions: This paper presents findings from a significant campus-wide physical and mental health surveillance initiative. Results indicate the need for targeted physical and mental health support and intervention among these demographic groups. [ABSTRACT FROM AUTHOR]

This paper explores the dynamics of caregiver rejection experienced by 40 homeless young adults 19-21 years of age. Using qualitative interviews, our findings reveal that nearly all of the youth reported at least one type of familial rejection that was intertwined with wider household conflict, and several youth experienced multiple types of rejection. Many young people reported 'feeling like an outsider,' as they felt marginalized by family members and perceived a sense of outsiderness within their family networks. Some youth cited rejection when they were 'betrayed by a primary caregiver for a significant other.' These intimate partners, such as a boyfriend, girlfriend or stepparent, often abused the young person, which exacerbated their experiences with caregiver rejection. Numerous youth were 'pushed into institutional living,' such as foster care or group homes, at the behest of their primary caregivers, which stemmed from familial discord and behavioral issues on the part of the young person. In the most explicit form of rejection, youth were 'kicked out by a caregiver' and subsequently entered into street life when they had nowhere else to go. Implications of these experiences are discussed, which can impact homeless young people's future life chances as they attempt to exit the street. [ABSTRACT FROM AUTHOR]

Purpose -- There is a growing need for school-based nutritional educational programs that promote healthy eating attitudes without increasing an unhealthy focus on restrictive eating or promoting a poor body image. Research suggests that intuitive eating (IE) approaches, which encourage individuals to focus on internal body signals as a guide for eating, have had a positive impact on eating-related psychological outcomes in adults. The purpose of this paper is to investigate the effects an IE education program on the eating attitudes of high school students. Design/methodology/approach -- In a quasi-experimental study, 48 high school students (30 females) in a Midwest town in the USA received instruction on IE or a comparison program over seven days during health classes. Repeated measures analyses of covariance were conducted to examine changes in eating attitudes in sexes across conditions. Findings -- Students who received the IE program made significantly greater gains in overall positive eating attitudes on the Intuitive Eating Scale than students in the comparison program ( p = 0.045), as well as on the Unconditional Permission to Eat subscale ( p = 0.02). There were no significant effects of sex on any of the analyses. Research limitations/implications -- Because of the relatively small sample size and short duration of the program, the results should be generalized with caution. Practical implications -- The results suggest that IE instruction may encourage the development of healthy eating attitudes in high school students, and health teachers may wish to consider including IE instruction in the health curriculum. Originality/value -- This is the first study to examine the effectiveness of an IE program in a K-12 population, with instruction provided in the context of the school. The results are promising and suggest that this may be a fruitful area for future research in nutrition education. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this research is to explore the relationships among psychological needs, motivation regulations, autonomy support, and physical activity (PA) behavior in rural and urban postmenopausal women within the Self Determination Theory (SDT) framework. Sample: The convenience sample included 114 rural postmenopausal women (RPMW) and 56 urban postmenopausal women (UPMW) recruited from three Midwestern states. Method: Subjects completed surveys in paper form which included instruments to measure basic psychological needs, motivation regulations, autonomy support, and PA behavior. Findings: Results indicate a mix of relationships among psychological needs and intrinsic motivation in rural and urban women. There was a significant correlation (r = .274, n = 169, p = 0.04) between intrinsic motivation and relatedness in RPMW, indicating these women find motivation in meaningful relationships. Conclusions: The strength of this research exists in the introduction of a significant correlation between intrinsic motivation to exercise and relatedness in RPMW. Previous work with SDT has shown autonomy and competence as motivating factors regarding physical activity behavior in women. This research indicates that for RPMW relatedness is also an important determinant of intrinsic motivation. This data suggests that psychological needs and motivational regulations are dissimilar for RPMW and UPMW regarding exercise behavior. [ABSTRACT FROM AUTHOR]

Screens and adjunctive treatments for perinatal mood are available, but barriers prevent many women from receiving them. Mobile technology may help bypass barriers. The purpose of this study was to evaluate the feasibility of screening and texting perinatal women via their personal smartphones. This prospective cohort study enrolled 203 pregnant and postpartum women receiving obstetric care at a Midwestern US academic medical center. Participants received one electronic mood screen and three text messages per week for two weeks. Texts were based on the Mothers and Babies Course, a CBT-based preventative program that addresses limited social support, lack of pleasant activities, and harmful thought patterns. Feasibility was defined as the ability to take the mood screen and receive texts without technical difficulties. Demographic variables were paired with results. Insurance type (private or public) was used as a proxy for socioeconomic status. Pearson chi-squared tests were used to analyze the data. A text-based satisfaction survey was also administered. The sample was 72% privately insured and 28% publicly insured. Sixty-seven percent completed electronic screening. Screen completion was significantly associated with private insurance (OR = 3.8, 95% CI 2.00–7.30) and "married" status (OR = 1.93, 95% CI 1.01–3.70). Most survey respondents (92%) found it easy to receive the texts, and 76% responded with very favorable comments about the texts. Smartphone mood screening and supportive texting were technically feasible. Screen completion was lower among single women with public insurance. [ABSTRACT FROM AUTHOR]

Aim: To fill the gap in research that historically has been limited by focusing on the health problems experienced by people of color. Method: A simulation exercise was developed for senior pre-licensure nursing students in their senior year of a pre-licensure nursing program at a Midwest liberal arts college to intervene when a health-care provider in the hospital acted in an oppressive manner toward a client. Results: Qualitative findings suggest the value of addressing structural racism during a simulated learning experience to facilitate an understanding of the extent of racism inherent in the health-care system and biases that can be perpetuated by health-care providers. Conclusions and Implication for Practice: This simulation on the topic of implicit bias and racism in the health-care system provided an opportunity to open and deepen important conversations about equity, belonging, and justice. Additional work is needed in training professional nurses to lead meaningful change in dealing with the current inequities in our health-care system. [ABSTRACT FROM AUTHOR]

Teacher-level factors are theoretically linked to student outcomes in data-based instruction (DBI; Lembke et al., 2018). Professional development and ongoing support can increase teachers' knowledge, skills, and beliefs related to DBI, as well as their instructional fidelity (McMaster et al., 2020). However, less is known about how each of these teacher-level factors influences student progress during an intervention. The purpose of this study was to examine the association between several important teacher-level factors—teachers' writing instruction fidelity, knowledge and skills related to DBI, explicit writing orientation, and writing instruction self-efficacy—and students' writing growth. Participants were 49 U.S. elementary teachers and their 118 students struggling with early writing skills. Using hierarchical linear modeling, we found a significant positive relation between DBI knowledge and skills and student writing growth, but no relation was found between writing instruction fidelity, writing orientation, or self-efficacy and student writing growth. Implications for writing instruction fidelity measurement in DBI and professional development related to teachers' DBI knowledge and skills are discussed. [ABSTRACT FROM AUTHOR]

Asian Americans are less likely than Whites to seek mental care and when they do, there is a substantial delay in help-seeking. Stigma associated with mental health service use is one of the major barriers to help-seeking among Asian Americans. However, few studies have examined multi-layered contextual predictors of stigma to examine joint as well as unique contributions of each predictor. Using a cross-sectional study of 376 Filipino and 412 Korean American parents from the Midwestern U.S., we investigated how individual, familial, ethnic cultural, and macro level factors were associated with stigma among immigrant parents. The findings from hierarchical regressions suggest that familial and ethnic cultural factors are prominent predictors of stigma among Korean Americans, whereas macro level factors are particularly pertinent to Filipino Americans. This study highlights the significance of subgroup specific interventions to be effective in addressing unmet mental care needs in distinct subgroups of Asian Americans. [ABSTRACT FROM AUTHOR]

Rapid Response Systems (RRS) improve patient outcomes at large medical centers. Little is known about how RRS are used in other medical settings. The purpose of this exploratory study was to describe RRS events at a long-term acute care hospital (LTACH). We conducted a retrospective review of 71 RRS event records at an urban 50-bed Midwestern LTACH. Measures included demographic data, triggering mechanisms, contextual factors, mechanism factors, and clinical outcomes. Of patients who experienced a RRS event, median age was 71 (62, 80) years; 52.1% were female; most (n = 49, 69%) were "full code." Most (n = 41, 58%) events occurred during the daytime. The most common trigger was "mental status changes/unresponsiveness." Registered nurses were the most frequent activator (n = 19, 26.8%) and responders (n = 63, 60.6%). Median duration of RRS events was 14 (6, 25) minutes. Most patients stabilized and their condition improved (n = 54, 76.1%). RRS can be expanded and modified to the LTACH population. [ABSTRACT FROM AUTHOR]

Objective: Assessing barriers to adherence provides helpful information to clinicians. The objective of this study was to describe the clinical utility of the Barriers Assessment Tool (BAT) using clinical data for a large, midwestern U.S. pediatric kidney transplant program. Methods: Focus group and clinical data were obtained during post-transplant medical visits. Qualitative and quantitative assessment methods were utilized to describe patient and caregiver feedback on the BAT, clinical utility, concordance between reporters, and the effect of interventions on subsequent assessment and electronically measured adherence. Results: Patients were willing to discuss adherence issues with their care team. There was substantial agreement between patients and caregivers at two timepoints. If a barrier was not addressed, 89.6% (43/48) of patients and 85.9% (67/78) of caregivers reported the same BAT scores from the first to second assessment. When barriers were addressed with a clinic-based intervention, 82% of caregivers reported no adherence barriers. No significant change was found for patient-reported barriers. Conclusions: Standardized assessment of barriers to medication adherence provides actionable information to clinicians. Standardized assessment of adherence barriers may give clinicians opportunities to help patients and caregivers overcome these barriers which can decrease risk of rejection. [ABSTRACT FROM AUTHOR]

Background: There is ongoing debate regarding how moral distress should be defined. Some scholars argue that the standard "narrow" definition overlooks morally relevant causes of distress, while others argue that broadening the definition of moral distress risks making measurement impractical. However, without measurement, the true extent of moral distress remains unknown. Research aims: To explore the frequency and intensity of five sub-categorizations of moral distress, resources used, intention to leave, and turnover of nurses using a new survey instrument. Research design: A mixed methods embedded design included a longitudinal, descriptive investigator-developed electronic survey with open-ended questions sent twice a week for 6 weeks. Analysis included descriptive and comparative statistics and content analysis of narrative data. Participants: Registered nurses from four hospitals within one large healthcare system in Midwest United States. Ethical considerations: IRB approval was obtained. Results: 246 participants completed the baseline survey, 80 participants provided data longitudinally for a minimum of 3 data points. At baseline, moral-conflict distress occurred with the highest frequency, followed by moral-constraint distress and moral-tension distress. By intensity, the most distressing sub-category was moral-tension distress, followed by "other" distress and moral-constraint distress. Longitudinally, when ranked by frequency, nurses experienced moral-conflict distress, moral-constraint distress, and moral-tension distress; by intensity, scores were highest for moral-tension distress, moral-uncertainty distress, and moral-constraint distress. Of available resources, participants spoke with colleagues and senior colleagues more frequently than using consultative services such as ethics consultation. Conclusions: Nurses experienced distress related to a number of moral issues extending beyond the traditional understanding of moral distress (as occurring due to a constraint) suggesting that our understanding and measurement of moral distress should be broadened. Nurses frequently used peer support as their primary resource but it was only moderately helpful. Effective peer support for moral distress could be impactful. Future research on moral distress sub-categories is needed. [ABSTRACT FROM AUTHOR]

Research has shown that strength of handedness – a proxy variable for the degree of interaction between the left and right brain hemispheres – predicts differences in a variety of cognitive domains. The present paper extends this work to message (or goal) framing effects in which persuasive health communications emphasise positive vs. negative outcomes. One hundred fifty-six participants read pamphlets containing statements emphasising either the gains of using or the losses of not using sunscreen. Replicating previous research, non-users of sunscreen were more affected by framed messages than users. However, we found a loss- rather than gain-framed advantage, and mixed (inconsistent)-handers seemed to drive these effects more so than strong (consistent)-handers. These results suggest that a ‘one-size-fits-all’ approach may be inadequate in crafting effective educational messages about health behaviours, and that theories centring around one’s regulatory focus orientation as well as new methods in laterality research may be useful in reaching the widest range of individuals. [ABSTRACT FROM PUBLISHER]

A laboratory experiment, funded by the U.S. National Institutes of Health, involved 243 U.S. undergraduate students and employed a 2 (gain-framed vs. loss-framed) × 2 (high vs. low threat) plus control group pretest-posttest experimental design to assess the combined effects of frame (gain vs. loss) and level of threat of public service announcements (PSAs) about marijuana on attitudes, beliefs, and intentions related to marijuana, as well as the relationship of message condition to ratings of PSAs. Results suggest that loss-framed messages may lead to greater perceived threat, as well as reactance, and gain-framed messages may lead to a greater reduction in positive attitudes toward marijuana than loss-framed messages. Finally, frame and threat may interact in a complex way. Further research is suggested to replicate these findings. A substantial body of carefully crafted and systematic research studies examining both content and features of messages increasingly informs mass media prevention efforts, including the development of public service announcements (PSAs). Although the significance of messages on commercial broadcast stations may be diminishing with the increasing role and impact of new media, many of the basic questions addressed by this research are likely to apply across media channels. Nonetheless, important questions about what makes a message effective in changing an individual's attitudes or behavior remain to be answered. In this paper, the authors focus on two theoretically derived strategies that offer possibilities for developing persuasive messages: framing and threat. [ABSTRACT FROM AUTHOR]

This paper applies a sociology of childhood approach to the study of the sexual socialisation of young children in the USA. It examines both children's and parents' active participation in this dynamic and collaborative process through conversations between 49 parents and their 54 preschool children that were audio-recorded while they read books about ‘where babies come from’. Parents also participated in a brief survey. The authors found that, while parents do foreclose such conversations as previous research has indicated, they also use a variety of other tactics, including adding information and emotion management. These findings illustrate children's active engagement in their own sexual socialisation through their questions, confusions and distractions, which affected the amount and type of information that was elicited. [ABSTRACT FROM PUBLISHER]