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BackgroundType 2 diabetes is a growing public health problem amenable to prevention and health promotion. As healthy behaviors have an impact on disease outcomes, approaches to support and sustain diabetes self-management are vital. ObjectiveThis study aimed to evaluate the effectiveness of a nurse coaching program using motivational interviewing paired with mobile health (mHealth) technology on diabetes self-efficacy and self-management for persons with type 2 diabetes. MethodsThis randomized controlled trial compared usual care with an intervention that entailed nurse health coaching and mHealth technology to track patient-generated health data and integrate these data into an electronic health record. The inclusion criteria were as follows: (1) enrolled at 1 of 3 primary care clinics, (2) aged 18 years or above, (3) living with type 2 diabetes, and (4) English-speaking. We collected outcome measures at baseline, 3 months, and 9 months. The primary outcome was diabetes self-efficacy; secondary outcomes were depressive symptoms, perceived stress, physical functioning, and emotional distress and anxiety. Linear regression mixed modeling estimated the population trends and individual differences in change. ResultsWe enrolled 319 participants; 287 participants completed the study (155 control and 132 intervention). The participants in the intervention group had significant improvements in diabetes self-efficacy (Diabetes Empowerment Scale, 0.34; 95% CI –0.15,0.53; P

BackgroundRandomized controlled trials conducted in Mediterranean countries have shown that the Mediterranean diet lowers adverse cardiovascular events. In the American population, diet remains the biggest uncontrolled risk factor for cardiovascular disease. ObjectiveThis study aimed to test the hypothesis that asynchronous dietary counseling supplied through a custom smartphone app results in better adherence to a Mediterranean diet in a non-Mediterranean population than traditional standard-of-care (SOC) counseling. MethodsIn total, 100 patients presenting to the cardiology clinic of an academic medical center were randomized to either the SOC or smartphone app-based experimental (EXP) Mediterranean diet intervention after informed consent and 1 hour of individual face-to-face dietary counseling with a registered dietitian. Participants in EXP received a custom smartphone app that reinforced the Mediterranean diet, whereas participants in SOC received 2 additional sessions of in-person dietary counseling with the registered dietitian—30 min at 1 month and 30 min at 3 months. Preexisting knowledge of a Mediterranean diet was measured by the validated Mediterranean Diet Score (MDS) instrument. Baseline height, weight, blood pressure (BP), and laboratory biomarkers were collected. At 1, 3, and 6 months, participants presented for a follow-up appointment to assess compliance to the Mediterranean diet using the MDS as well as a patient satisfaction survey, BP, and weight. Repeat laboratory biomarkers were performed at 3 and 6 months. ResultsEnrolled participants had a mean age with SE of 56.6 (SD 1.7) for SOC and 57.2 (SD 1.8) for EXP; 65.3% of SOC and 56.9% of EXP were male, and 20.4% of SOC and 35.3% of EXP had coronary artery disease. There were no significant differences between EXP and SOC with regard to BP, lipid parameters, hemoglobin A1c, or C-reactive protein (CRP). Participants in EXP achieved a significantly greater weight loss on average of 3.3 pounds versus 3.1 pounds for participants in SOC, P=.04. Adherence to the Mediterranean diet increased significantly over time for both groups (P

OBJECTIVE: Characterize key factors and training needs of U.S. cancer centers in implementing family caregiver support services. METHODS: Sequential explanatory mixed methods design consisting of: (1) a national survey of clinicians and administrators from Commission-on-Cancer-accredited cancer centers (N = 238) on factors and training needed for establishing new caregiver programs and (2) qualitative interviews with a subsample of survey respondents (N = 30) to elicit feedback on survey findings and the outline of an implementation strategy to facilitate implementation of evidence-based family caregiver support (the Caregiver Support Accelerator). Survey data was tabulated using descriptive statistics and transcribed interviews were analyzed using thematic analysis. RESULTS: Top factors for developing new caregiver programs were that the program be: consistent with the cancer centers mission and strategic plan (87%), supported by clinic leadership (86.5%) and providers and staff (85.7%), and low cost or cost effective (84.9%). Top training needs were how to: train staff to implement programs (72.3%), obtain program materials (63.0%), and evaluate program outcomes (62.6%). Only 3.8% reported that no training was needed. Qualitative interviews yielded four main themes: (1) gaining leadership, clinician, and staff buy-in and support is essential; (2) cost and clinician burden are major factors to program implementation; (3) training should help with adapting and marketing programs to local context and culture; and (4) the Accelerator strategy is comprehensive and would benefit from key organizational partnerships and policy standards. CONCLUSION: Findings will be used to inform and refine the Accelerator implementation strategy to facilitate the adoption and growth of evidence-based cancer caregiver support in U.S. cancer centers.

This article focuses on one university literacy camp for kindergarten through sixth grade students that shifted from traditional in-person instruction to a virtual setting during the COVID-19 pandemic. The change from an in-person camp to a virtual camp setting created an opportunity for research in investigating students' attitudes towards literacy, literacy learning, and participation within the newly formatted virtual literacy camp. Twenty-six kindergarten through sixth grade students were interviewed at the beginning and conclusion of a semester-long literacy camp regarding their attitudes toward learning and participation in the literacy camp. Throughout the data, researchers noted the theme of relationships as being prevalent with many participants sharing thoughts specifically in light of the lack of outside interaction during this more isolated era of time. The relationships built between the tutors and the students in this virtual camp were vital to the attitudes and the learning of these study participants. This study provides further direction for supporting students in a virtual literacy clinic setting.

BackgroundDespite the recent explosion of the mobile health (mHealth) industry and consumer acquisition of mHealth tools such as wearable sensors and applications (apps), limited information is known about how this technology can sustain health behavior change and be integrated into health care. ObjectiveThe objective of the study was to understand potential users’ views of mHealth technology, the role this technology may have in promoting individual activity goals aimed at improving health, and the value of integrating mHealth technology with traditional health care. MethodsFour focus groups were conducted with adults interested in sharing their views on how mHealth technology could support wellness programs and improve health. Participants (n=30) were enrolled from an employee population at an academic health institution. Qualitative thematic analysis was used to code transcripts and identify overarching themes. ResultsOur findings suggest that tracking health data alone may result in heightened awareness of daily activity, yet may not be sufficient to sustain use of mHealth technology and apps, which often have low reuse rates. Participants suggested that context, meaning, and health care partnerships need to be incorporated to engage and retain users. In addition to these findings, drivers for mHealth technology previously identified in the literature, including integration and control of health data were confirmed in this study. ConclusionsThis study explores ways that mHealth technologies may be used to not only track data, but to encourage sustained engagement to achieve individual health goals. Implications of these findings include recommendations for mHealth technology design and health care partnership models to sustain motivation and engagement, allowing individuals to achieve meaningful behavior change.

BackgroundFamily-centered rounds is recognized as a best practice for hospitalized children, but it has only been possible for children whose families can physically be at the bedside during hospital rounds. The use of telehealth to bring a family member virtually to the child's bedside during hospital rounds is a promising solution. We aim to evaluate the impact of virtual family-centered hospital rounds in the neonatal intensive care unit on parental and neonatal outcomes.MethodsThis two-arm cluster randomized controlled trial will randomize families of hospitalized infants to have the option to use telehealth for virtual hospital rounds (intervention) or usual care (control). The intervention-arm families will also have the option to participate in hospital rounds in-person or to not participate in hospital rounds. All eligible infants who are admitted to this single-site neonatal intensive care unit during the study period will be included. Eligibility requires that there be an English-proficient adult parent or guardian. We will measure participant-level outcome data to test the impact on family-centered rounds attendance, parent experience, family-centered care, parent activation, parent health-related quality of life, length of stay, breastmilk feeding, and neonatal growth. Additionally, we will conduct a mixed methods implementation evaluation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.DiscussionThe findings from this trial will increase our understanding about virtual family-centered hospital rounds in the neonatal intensive care unit. The mixed methods implementation evaluation will enhance our understanding about the contextual factors that influence the implementation and rigorous evaluation of our intervention.Trial registrationClinicalTrials.gov Identifier: NCT05762835. Status: Not yet recruiting. First posted: March 10, 2023; last update posted: March 10, 2023.

BackgroundChildren presenting to emergency departments of community hospitals may require transfer to a children's hospital for more definitive care, but the transfer process can be distressing and burdensome to patients, families, and the healthcare system. Using telehealth to bring the children's hospital nurse virtually to the bedside of the child in the emergency department has the potential to promote family-centered care and minimize triage issues and other transfer-associated burdens. To explore the feasibility of the nurse-to-family telehealth intervention, we are conducting a pilot study.MethodsThis parallel cluster randomized controlled feasibility and pilot trial will randomize six community emergency departments to use either nurse-to-family telehealth (intervention) or usual care (control) for pediatric inter-facility transfers. All eligible children presenting to a participating site during the study period who require inter-facility transfer will be included. Eligibility requires that there be an English-speaking adult parent or guardian at the emergency department bedside. We will examine feasibility objectives that assess protocol assignment adherence, fidelity, and survey response rates. We will measure subject-level exploratory outcome data to test feasibility of data collection and to obtain effect size estimates; exploratory outcomes include family-centered care, family experience, parent acute stress, parent distress, and change in level of care. Additionally, we will conduct a mixed methods implementation evaluation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.DiscussionThe findings from this trial will increase our understanding about nurse-to-family telehealth during pediatric transfers. The mixed methods implementation evaluation will provide relevant insight about the contextual factors that influence the implementation and rigorous evaluation of our intervention.Trial registrationClinicalTrials.gov Identifier: NCT05593900. First Posted: October 26, 2022. Last Update Posted: December 5, 2022.

BackgroundType 2 diabetes mellitus is a worldwide challenge. Practice guidelines promote structured self-monitoring of blood glucose (SMBG) for informing health care providers about glycemic control and providing patient feedback to increase knowledge, self-efficacy, and behavior change. Paired glucose testing—pairs of glucose results obtained before and after a meal or physical activity—is a method of structured SMBG. However, frequent access to glucose data to interpret values and recommend actions is challenging. A complete feedback loop—data collection and interpretation combined with feedback to modify treatment—has been associated with improved outcomes, yet there remains limited integration of SMBG feedback in diabetes management. Incorporating telehealth remote monitoring and asynchronous electronic health record (EHR) feedback from certified diabetes educators (CDEs)—specialists in glucose pattern management—employ the complete feedback loop to improve outcomes. ObjectiveThe purpose of this study was to evaluate a telehealth remote monitoring intervention using paired glucose testing and asynchronous data analysis in adults with type 2 diabetes. The primary aim was change in glycated hemoglobin (A1c)—a measure of overall glucose management—between groups after 6 months. The secondary aims were change in self-reported Summary of Diabetes Self-Care Activities (SDSCA), Diabetes Empowerment Scale, and Diabetes Knowledge Test. MethodsA 2-group randomized clinical trial was conducted comparing usual care to telehealth remote monitoring with paired glucose testing and asynchronous virtual visits. Participants were aged 30-70 years, not using insulin with A1c levels between 7.5% and 10.9% (58-96 mmol/mol). The telehealth remote monitoring tablet computer transmitted glucose data and facilitated a complete feedback loop to educate participants, analyze actionable glucose data, and provide feedback. Data from paired glucose testing were analyzed asynchronously using computer-assisted pattern analysis and were shared with patients via the EHR weekly. CDEs called participants monthly to discuss paired glucose testing trends and treatment changes. Separate mixed-effects models were used to analyze data. ResultsParticipants (N=90) were primarily white (64%, 56/87), mean age 58 (SD 11) years, mean body mass index 34.1 (SD 6.7) kg/m2, with diabetes for mean 8.2 (SD 5.4) years, and a mean A1c of 8.3% (SD 1.1; 67 mmol/mol). Both groups lowered A1c with an estimated average decrease of 0.70 percentage points in usual care group and 1.11 percentage points in the treatment group with a significant difference of 0.41 percentage points at 6 months (SE 0.08, t159=–2.87, P=.005). Change in medication (SE 0.21, t157=–3.37, P=.009) was significantly associated with lower A1c level. The treatment group significantly improved on the SDSCA subscales carbohydrate spacing (P=.04), monitoring glucose (P=.001), and foot care (P=.02). ConclusionsAn eHealth model incorporating a complete feedback loop with telehealth remote monitoring and paired glucose testing with asynchronous data analysis significantly improved A1c levels compared to usual care. Trial RegistrationClinicaltrials.gov NCT01715649; https://www.clinicaltrials.gov/ct2/show/NCT01715649 (Archived by WebCite at http://www.webcitation.org/6ZinLl8D0).

AimTo identify the contextual factors influencing parents' assessments of the family-centredness of care received during a paediatric emergency department visit.DesignA qualitative cross-sectional case study.MethodsWe interviewed parents who were at their child's bedside during an emergency department encounter. We independently coded the first 3 transcripts and met to discuss the coding structure and to refine existing codes, add new codes and develop tentative categories. We repeated this process for every 3-5 transcripts until thematic saturation was reached.ResultsWe conducted 16 interviews and identified 2 themes: (1) Not all parents expected physicians to provide family-centred care in the emergency department and (2) feeling overwhelmed and powerless influenced parents' perceptions of family-centred care. Poor family-centred care worsened parents' sense of powerlessness and reinforced parents' low expectations from physicians. Similarly, low expectations and powerlessness exacerbated poor family-centred care. Interventions are needed to break this cycle and improve family-centredness of care.

The student teaching experience is often an important capstone experience of teacher preparatory programs. Student teaching is designed to provide college students who are preparing to be educators with experience in an actual classroom while supervised by a certified teacher. The purpose of this study was to determine preservice teachers' perceptions of important elements of the student teaching experience both before and after the student teaching experience. The preservice teachers perceived the most important element of the student teaching experience was the cooperating teacher/student teacher relationship. Additionally, there was a negative change in the perceived level of importance for all students to have an SAE requirement, with accurate record books and diversity within the students' SAEs from much importance to medium importance. When placing preservice teachers for the student teaching internship, teacher educators might consider placing a higher emphasis on the cooperating teacher/student teacher relationships. Secondly, when placing preservice teachers for the student teaching internship, teacher educators could choose internship sites that emphasize SAE programs and have diverse facilities. Finally, we recommend future research could be conducted to further explore the role of the cooperating teacher and the important aspects of the cooperating teacher/student teacher relationship.

Purpose: The purpose of this research was to explore the preparation of practitioners from two disciplines--speech-language pathology and elementary education--who often work together in a school setting to identify ways to best support future professionals in their educational practicum settings. The primary research questions guiding this investigation were as follows: Did the student teaching and supervision experiences of preservice K-6 teachers (PSTs) and their mentors and speech-language pathology graduate student clinicians and their supervisors differ during the COVID-19 pandemic, and if so, in what ways? Method: A total of 54 participants from one university participated in this study from four groups: 15 graduate student clinicians in a speech-language pathology program, 14 speech-language pathology supervisors, 14 PSTs, and 11 teacher mentors. Survey questions were designed to capture the perceptions of students and supervisors in the fields of speech-language pathology and elementary education who were in the school setting during the fall 2020 semester. Quantitative and qualitative questions were included to obtain information related to the following areas: planning, environment, supervision preferences, team experiences, professional development, and telepractice. Results: Speech-language pathologists and teacher mentors reported being able to successfully mentor and supervise students in the school setting despite significant challenges presented by the global pandemic. Findings also identified several significant differences in the experiences of PSTs and speech-language pathology graduate student clinicians who were in the schools for field experiences. Conclusions: Overall, speech-language pathology graduate student clinicians and their supervisors as well as PSTs and their teacher mentors reported adequately navigating their field experiences during the COVID-19 pandemic. Implications for how these findings can inform professional preparation programs to optimize future educational and therapy outcomes for students are discussed.

The pandemics of COVID-19 and systemic racism highlighted health inequities that have existed for decades among Black communities. Nurses are positioned to address these health inequities through innovative ideas and research. More specifically, Black nurses, because of their shared lived experience, understand sociostructural factors underpinning health inequities and how to best engage with Black communities. However, only 8% of Black nurses make up the overall nursing workforce and far fewer are nurse scientists. Historically Black Colleges and Universities (HBCUs) can offer critically important options for success in addressing the dearth of Black nurse scientists working across sectors and contributing to rich academic milieu, informing innovative national policy, and creating impactful practice. We discuss challenges and strategies to promoting research careers at HBCUs to attract Black nurse scientists as the next leaders in health inequities research.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers who perform wound care tasks. Each article also includes an informational tear sheet-Information for Family Caregivers-that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers who perform wound care tasks. Each article also includes an informational tear sheet-Information for Family Caregivers-that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.

BackgroundWith the aging population, family caregivers provide increasingly complex and intense care for older adults and persons with disabilities. There is growing interest in developing community-based services to support family caregivers. Caregiving occurs around the clock, and caregivers face challenges in accessing community-based services at convenient times owing to the demands of care. Web-based resources hold promise for accessible real-time support. CareNav (TM), a caregiver resource information system, is a web-based platform designed to support real-time universal caregiver assessment, a record of client encounters, development of a care plan, tailored information and resource content, access to web-based caregiver resources, the capacity to track service authorization and contracts, and secure communications. The assessment includes needs and health conditions of both the care recipient and caregiver; current resources; and priorities for support, information, and referral. In 2019, the California Department of Health Care Services funded the 11 nonprofit California Caregiver Resource Centers (CRCs) to expand and improve family caregiver services and enhance CRC information technology services. Deployment of a statewide information system offered a unique opportunity to examine structures and processes facilitating implementation, providing feedback to the sites as well as lessons learned for similar projects in the future.ObjectiveThe aim of this paper was to describe the statewide implementation of the comprehensive CareNav system using the Consolidated Framework for Implementation Research as an organizing structure for synthesizing the evaluation.MethodsThis mixed methods study used two major approaches to evaluate the implementation process: a survey of all staff who completed training (n=82) and in-depth qualitative interviews with 11 CRC teams and 3 key informants (n=35). We initially analyzed interview transcripts using qualitative descriptive methods and then identified subthemes and relationships among ideas, mapping the findings to the Consolidated Framework for Implementation Research.ResultsWe present findings on the outer setting, inner setting, characteristics of the intervention, characteristics of the staff, and the implementation process. The critical elements for success were leadership, communication, harmonization of processes across sites, and motivation to serve clients in more accessible and convenient ways.ConclusionsThese findings have implications for technology deployment in diverse community-based agencies that aspire to enhance web-based services.

The pandemics of COVID-19 and systemic racism highlighted health inequities that have existed for decades among Black communities. Nurses are positioned to address these health inequities through innovative ideas and research. More specifically, Black nurses, because of their shared lived experience, understand sociostructural factors underpinning health inequities and how to best engage with Black communities. However, only 8% of Black nurses make up the overall nursing workforce and far fewer are nurse scientists. Historically Black Colleges and Universities (HBCUs) can offer critically important options for success in addressing the dearth of Black nurse scientists working across sectors and contributing to rich academic milieu, informing innovative national policy, and creating impactful practice. We discuss challenges and strategies to promoting research careers at HBCUs to attract Black nurse scientists as the next leaders in health inequities research.

Persons with dementia (PWD) often experience difficulty navigating their environments and performing out-of-home activities. Life-space mobility (LSM) is an effective way of assessing functional levels and independence. We present a dyadic case study to explore the feasibility of using a global positioning system (GPS) watch to measure LSM of a Latino PWD. Methods included travel diary, LSM questionnaire, and qualitative interviews in addition to the GPS-based mobility characterization. GPS data indicated that the PWD made outdoor trips regularly and was active socially, with day-to-day variations. Caregiver and PWD interviews revealed contextual information about mobility patterns captured by other methods. The dyad had positive perceptions of the GPS watch for tracking health and activities. This study demonstrated a use for wearable location tracking technology to support accurate LSM assessment in dementia that can inform nursing practice, policy, and research to promote well-being and delay functional deterioration in PWD. [Journal of Gerontological Nursing, 47(10), 15-22.].

Building a classroom library while infusing multicultural (MC) content and multiple perspectives into the learning environment is an important job for teachers. Students need to have direct access to meaningful and relevant texts, and the classroom library is the optimal location. Teacher educators should strive to assist teacher candidates in building anti-bias libraries in early childhood and elementary programs with a wide variety of literature. Undoubtedly, teacher candidates wonder where and how to begin the process of selecting the best texts for their future libraries. How is it possible to know which books are the highest quality children's literature that represent a diverse reading list and demonstrate universal human experiences across a variety of cultures? In this article, the authors recommend that by using the six MC principles (Bennett, 2014) as a foundation and employing an evaluation checklist (see Appendix B) designed to elucidate literary criticism and absence of bias, teacher candidates will be able to develop and expand classroom libraries in the most culturally responsive manner. The purpose of this article is to underscore critical attention on educating the nation's teachers by developing a critical eye for high-quality MC literature that is available for the classroom as well as an ongoing commitment to seeking out the most effective array of literature for the children in their classrooms.

ObjectiveTo explore multi-clinician perspectives on intensive care early mobility, monitoring and to assess the perceived value of technology-generated mobility metrics to provide user feedback to inform research, practice improvement, and technology development.MethodsWe performed a qualitative descriptive study. Three focus groups were conducted with critical care clinicians, including nurses (n = 10), physical therapists (n = 8) and physicians (n = 8) at an academic medical centre that implemented an intensive care early mobility programme in 2012. Qualitative thematic analysis was used to code transcripts and identify overarching themes.FindingsAlong with reaffirming the value of performing early mobility interventions, four themes for improving mobility monitoring emerged, including the need for: 1) standardised indicators for documenting mobility; 2) inclusion of both quantitative and qualitative metrics to measure mobility 3) a balance between quantity and quality of data; and 4) trending mobility metrics over time.ConclusionIntensive care mobility monitoring should be standardised and data generated should be high quality, capable of supporting trend analysis, and meaningful. By improving measurement and monitoring of mobility, future researchers can examine the arc of activity that patients in the intensive care unit undergo and develop models to understand factors that influence successful implementation.

The purpose of this phenomenological study was to explain how the Common Core State Standards may have influenced teachers' practices and philosophies regarding literacy instruction. Conducted in five kindergarten through second-grade classrooms within one elementary school, this research study collected semi-structured interviews, classroom observations, and teacher-reported lesson plans over fourteen weeks. We observed that one of the largest instructional shifts due to the implementation of new standards was in the area of informational text use. This change came about not due to the volume of empirical research stating the benefits of such texts, but rather because of an educational policy change. These findings hold implications for K-12 schools and for teacher education programs which are, in many instances, caught between the research, policies, and practice.

IntroductionThe imperative of medicine is to treat suffering and to cure when possible. This learning module has been designed to expand providers' knowledge of how to sustain life, restore health, relieve suffering, and provide comfort for people who are experiencing cancer-induced pain. The module uses cancer pain as the context through which students can learn interprofessional, team-based, and person-centered approaches to delivery of care.MethodsUsing the facilitator's guide, handouts, and other materials developed for this project, the module can be delivered as an in-person training session (approximately 120 minutes) for small groups of learners (teams of eight to 12 students drawn from multiple health care professions or schools). Prelearning materials and postsession activities are included that can enhance the experience.ResultsThis module was developed and tested with two pilot programs that were evaluated with focus groups, direct observation, and a postsession survey completed by learners. Data demonstrated high approval of and appreciation for the content and structure of the module by both learners and facilitators.DiscussionMany learners work with other health care professionals in their clinical experiences but have not had opportunities to effectively work in interprofessional collaborative practice. This interprofessional education activity allows students from disparate health professions to work together to identify patient-centered treatment options through interprofessional collaborative teamwork in a classroom setting.

To compare the accuracy of electronic health record clinician documentation and accelerometer-based sensors with a gold standard dataset derived from clinician-annotated video to quantify early mobility activities in adult ICU patients.DesignProspective, observational study.SettingMedical ICU at an academic hospital.PatientsAdult ICU patients (n = 30) were each continuously monitored over a median of 24.4 hours, yielding 711.5 hours of video, electronic health record, and sensor data.InterventionsNone.Measurements and main resultsElectronic health record documentation estimated ambulation (intraclass correlation coefficient, 0.89; 95% CI, 0.78-0.95), sitting out-of-bed (intraclass correlation coefficient, 0.85; 95% CI, 0.72-0.93), and turning events (intraclass correlation coefficient, 0.87; 95% CI, 0.75-0.94) with excellent agreement but underestimated the number of standing, transferring, and pregait activities performed per patient. The accelerometer-based sensor had excellent agreement with video annotation for estimating duration of time spent supine (intraclass correlation coefficient, 0.99; CI, 0.97-0.99) and sitting/standing upright (intraclass correlation coefficient, 0.92; CI, 0.82-0.96) but overestimated ambulation time.ConclusionsOur results show that electronic health record documentation and sensor-based technologies accurately capture distinct but complimentary metrics for ICU mobility measurement. Innovations in artifact detection, standardization of clinically relevant mobility definitions, and electronic health record documentation enhancements may enable further use of these technologies to drive critical care research and technology leveraged data-driven ICU models of care.

BACKGROUND AND OBJECTIVES:Although most people have some experience as caregivers, the nature and context of care are highly variable. Caregiving, socioeconomic factors, and health are all interrelated. For these reasons, caregiver interventions must consider these factors. This review examines the degree to which caregiver intervention research has reported and considered social determinants of health. RESEARCH DESIGN AND METHODS:We examined published systematic reviews and meta-analyses of interventions for older adults with age-related chronic conditions using the PRISMA and AMSTAR 2 checklists. From 2,707 papers meeting search criteria, we identified 197 potentially relevant systematic reviews, and selected 33 for the final analysis. RESULTS:We found scant information on the inclusion of social determinants; the papers lacked specificity regarding race/ethnicity, gender, sexual identity, socioeconomic status, and geographic location. The majority of studies focused on dementia, with other conditions common in later life vastly underrepresented. DISCUSSION AND IMPLICATIONS:Significant gaps in evidence persist, particularly for interventions targeting diverse conditions and populations. To advance health equity and improve the effectiveness of interventions, research should address caregiver heterogeneity and improve assessment, support, and instruction for diverse populations. Research must identify aspects of heterogeneity that matter in intervention design, while recognizing opportunities for common elements and strategies.