Recent Research Publications and Funding

  •  | June 26, 2014 3:00AM

    Background: The Robert Wood Johnson Foundation Nurse Faculty Scholars (RWJF NFS) program was developed to enhance the career trajectory of young nursing faculty and to train the next generation of nurse scholars. Although there are publications that describe the RWJF NFS, no evaluative reports have been published. The purpose of this study was to evaluate the first three cohorts (n = 42 scholars) of the RWJF NFS program.

    Methods: A descriptive research design was used. Data were derived from quarterly and annual reports, and a questionnaire (seven open-ended questions) was administered via Survey Monkey Inc. (Palo Alto, CA, USA).

    Results: During their tenure, scholars had on average six to seven articles published, were teaching/mentoring at the graduate level (93%), and holding leadership positions at their academic institutions (100%). Eleven scholars (26%) achieved fellowship in the American Academy of Nursing, one of the highest nursing honors. The average ratings on a Likert scale of 1 (not at all supportive) to 10 (extremely supportive) of whether or not RWJF had helped scholars achieve their goals in teaching, service, research, and leadership were 7.7, 8.0, 9.4, and 9.5, respectively. The majority of scholars reported a positive, supportive relationship with their primary nursing and research mentors; although, several scholars noted challenges in connecting for meetings or telephone calls with their national nursing mentors.

    Conclusions: These initial results of the RWJF NFS program highlight the success of the program in meeting its overall goal—preparing the next generation of nursing academic scholars for leadership in the profession

  •  | June 24, 2014 3:00AM

    To describe the rate of contraceptive use and types of contraception used by low-income women.

  •  | June 16, 2014 3:00AM

    Incarcerated women often have arresting behaviors that are also high risk for acquiring HIV, such as drug use and sex work. Little research has been done related to HIV knowledge among women in jail. This study assessed HIV knowledge among English-speaking women 18 years and older detained in a large, Southeastern jail (N = 202). HIV knowledge was assessed using the Brief HIV Knowledge Questionnaire. HIV knowledge scores were significantly lower among women over age 50, F(3, 195) = 7.39, p < .001; those with less than a high school education, F(2, 187) = 4.10, p = .018; and those with no history of sexually transmitted infections, F(1, 200) = 7.66, p = .006. Assessment of HIV knowledge among incarcerated women revealed a need for prevention education.

  •  | June 2, 2014 3:00AM

    Major efforts have been directed toward the implementation of sustainable quality improvement. To date, progress has been noted using various metrics and performance measures; however, successful implementation has proven challenging. The Quality, Implementation, and Evaluation (QIE) model, derived from Donabedian's structure component, presents a framework for implementation of specific activities. The QIE model consists of Policy, Patient Preparedness, Provider Competency, and Performance and Accountability, to guide specific practice initiatives. The implementation of alcohol-based pre-operative skin prep was evaluated in a sample of 17 hospitals and demonstrated that hospitals actively engaged in the components of the model demonstrated a significantly higher use of alcohol-based skin preparation agent than hospitals that did not engage in QIE model activities. The QIE model presents a powerful and actionable implementation model for mid-level management and clinical leadership. Future studies will further evaluate the impact of the specific components of the QIE model.

    Interventions
  •  | June 1, 2014 3:00AM

    Aging with independence benefits individuals, family, and society. To achieve independence, older adults must be able to function in their homes. This function is determined both by their abilities and by the environment in which they maneuver. This article describes a promising program that intervenes with both older adults and their home environments to improve function. This program, called CAPABLE (Community Aging in Place, Advancing Better Living for Elders), is funded through the Affordable Care Act and can be scaled up nationally if determined to be a success in improving health and decreasing health care costs.

  •  | May 15, 2014 3:00AM

    While parental influences on adolescent health behaviors are well recognized, there is limited understanding of the relationship between adolescents’ perceptions of their parents’ expectations and their sexual behaviors. This mixed-methods study explored how White and Asian American adolescents perceive parental expectations via parent–child interactions, and how such expectations relate to adolescents’ self-reported sexual activities over time. Using gender-matched, in-depth interviews with 28 White and Asian American adolescents, ages 17 to 19, we explored adolescents’ perceptions of parental expectations about when, how, and under what conditions adolescents should engage in sexual activity. Stronger conservative parental sexual expectations and disapproving parental attitudes were closely related to later sexual debut and fewer sexual partners. Perceived closeness determined the degree to which adolescents respected and incorporated their parents’ beliefs, values, and sexual expectations. Future research should focus on developing family strategies to utilize the concept of perceived parental expectations.

  •  | May 13, 2014 3:00AM

    OBJECTIVE: To systematically evaluate the literature on anxiety disorders during pregnancy.

    DATA SOURCES: MEDLINE, PsycINFO, and CINAHL were searched through October 2013 for original research studies published in English using combinations of the terms pregnancy, prenatal, or pregnancy outcomes; anxiety disorder; and generalized anxiety. Reference lists of included studies were hand-searched and a PubMed search for in-process reports was conducted.

    STUDY SELECTION: Relevant studies of anxiety disorders during pregnancy as determined by diagnostic interview were included if they reported on prevalence; course, onset, and/or risk factors; maternal, obstetric, or fetal/child outcomes; and/or treatment trial results.

    DATA EXTRACTION: Two reviewers independently extracted relevant data and assessed methodological quality of each study.

    RESULTS: Fifty-seven reports were included. Reports provided information on panic disorder (25 reports), generalized anxiety disorder (17 reports), obsessive-compulsive disorder (OCD) (23 reports), agoraphobia (6 reports), specific phobia (10 reports), social phobia (14 reports), posttraumatic stress disorder (14 reports), and any anxiety disorder (18 reports). Twenty reports provided information on prevalence, 16 on course, 10 on risk factors, and 22 on outcomes. Only 1 treatment study was identified. High anxiety disorder prevalence in pregnancy was found; however, estimates vary considerably, and evidence is inconclusive as to whether prevalence among pregnant women differs from that of nonpregnant populations. Considerable variation in prenatal course of OCD and panic disorder was found. Substantial heterogeneity limits conclusions regarding risk factors or outcomes.

    CONCLUSIONS: Additional research of higher methodological quality is required to more accurately determine prevalence, understand course, identify risk factors and outcomes, and determine effective treatments for anxiety disorders in pregnancy.

  •  | May 11, 2014 3:00AM

    PURPOSE: To examine racial-ethnic differences in Epstein-Barr virus (EBV) antibody levels among U.S. children and adolescents. Elevated titers among seropositive youth can indicate viral reactivation-an indirect measure of impaired cell-mediated immunity.

    METHODS: Data from the 2003-2010 National Health and Nutrition Examination Survey were analyzed using multivariable linear regression accounting for the complex survey design and potential confounders. The sample comprised 4663 black-African American, Mexican American, and white youth aged 6-17 years who were EBV seropositive.

    RESULTS: EBV antibody levels were significantly higher for black-African American youth compared with their white peers (b = 0.343, P < .0001). Gender-stratified models were consistent with the total sample except differences in EBV antibody levels were greater between black-African American and white males (b = 0.525, P < .0001) than between black-African American and white females (b = 0.169, P = .0185). Differences in EBV antibody levels between Mexican American and white youth were only marginally significant in the total and the gender-stratified samples.

    CONCLUSIONS: Black-white differences in EBV antibody levels were found suggesting EBV reactivation and potential disparities in immune function among minority youth. Research on multilevel factors contributing to the disparities is needed, including potential health implications over the life course for minority youth.

  •  | May 7, 2014 3:00AM

    Purpose: Conducting research in a rural area can be challenging for nurses for a variety of different reasons. The task at hand can be especially difficult when it involves discussing a sensitive topic, such as Human Papillomavirus (HPV) vaccination. This study was conducted to describe parental perceptions of the HPV vaccine in rural areas, while simultaneously describing a method for engaging in successful nursing research in rural areas.

    Methods: A team of nurse researchers completed a planned process to first understand rural culture in southeastern Georgia, and then more specifically, the families living in these three separate counties. This process initially involved developing a connection and working relationship with key community leaders, such as school principals. Following this, researchers worked on establishing rapport and trust with local parents and research participants themselves. Qualitative methods were then used to collect focus group and interview data on parental views of HPV, HPV vaccination, and HPV-related cancers.

    Findings: Results indicated that parents had little knowledge of the HPV vaccine in rural Georgia, including misconceptions that the vaccine is for females only. In addition, many parents continually voiced the concern that the HPV vaccine would promote promiscuity in their children.

    Conclusions: Providing consistent, timely, and open communication with the community members was crucial throughout the entire research process. This focused approach with respect to total community, culture, and religious value is essential in conducting research. Future studies conducted in rural areas should focus on specific intervention points that improve Parental HPV knowledge.

  •  | April 17, 2014 3:00AM

    OBJECTIVE: We conducted a descriptive study of the correlates of refusal and acceptance of human papillomavirus (HPV) vaccination by rural parents of preadolescent and adolescent children. We hypothesized that the correlates of parents who allow their children aged 9 to 13 years to get the HPV vaccine and those of parents who do not allow vaccination would differ significantly.

    METHODS: This cross-sectional study was implemented during the school years 2009-2011 in the elementary and middle schools of three rural counties in Georgia. Parents were recruited at school functions to complete an anonymous validated survey.

    RESULTS: Parents who chose to vaccinate their children or intended to vaccinate were twice as likely to be from a race other than African American and 2.7 times more likely to have a religion other than Baptist. Using stepwise logistic regression and after adjustment for race and religion, we found that parents who had vaccinated or intended to vaccinate had significantly higher scores on perceived barriers (1.02 times more likely to vaccinate) and lower scores on perceived benefits (1.01 times more likely to vaccinate) (model p < .001).

    CONCLUSIONS: The results suggest that healthcare providers in rural areas can increase HPV vaccine uptake and reduce HPV-related cancers by using a multifaceted approach to educating their patients within the context of the patients' cultural values, geographic location, and economic situation. Such an approach could dispel misinformation and increase vaccine uptake.