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Limited nursing knowledge exists to explain how culture influences men's health care decisions and practices. The purpose of this collaborative research was to explore the health care meanings, values, expressions, lived experiences, and practices of Anglo-American adult males residing in the rural Midwest. Using the ethnonursing research method, data were collected through interviews with 7 key and 12 general informants residing in Iowa. Four culture values and five themes were supported by the findings. Leininger's culture care modes were used to explicate culturally meaningful nursing care actions and decisions that are in harmony with the cultural values and practices of rural men.

Historically, Iowa has had a majority of diploma and associate degree nursing graduates. Although educational mobility for registered nurses to obtain baccalaureate nursing degrees was available in Iowa before 1991, direct nursing education articulation did not exist. The impetus for developing a statewide nursing articulation plan to facilitate the entry of registered nurses to baccalaureate nursing programs was the result of a recommendation from the Iowa Board of Nursing's 1988 Statewide Plan for Nursing. The Iowa Articulation Plan for Nursing Education: RN to Baccalaureate, implemented in 1991, resulted from collaboration among nurse educators from all levels of nursing and nursing service representatives. The plan consists of four separate options and can be adapted for use in other parts of the country. The Iowa articulation story describes the process used and outcomes achieved when nurses collaborate to advance nursing education.