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Recent Research Publications and Funding
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August 6, 2012 4:00AM
BACKGROUND: University–community partnerships through coordinated school health programs (CSHP) can play a key role in decreasing child obesity. The main objective of this study was to measure over a 1-year period whether a CSHP with parental, school, and home-based components to promote optimal nutrition will reduce BMI percentiles and z-scores and improve dietary behaviors in a sample of low-income, school-aged children.
METHODS: The intervention included, Kids Nutrition and Fitness, a 6-week nutrition, physical activity educational after-school program, and school activities, including creation of an Advisory Committee that made wellness policies. A randomized controlled pilot study evaluated the effectiveness of the intervention that contrasts 251 (n = 251) predominantly Mexican-American 8 to 12 year olds from low-income Los Angeles–based schools. A mixed model of repeated measures analysis assessed changes in BMI percentiles and z-scores, dietary behaviors, food preferences, knowledge, and self-efficacy measured by a reliable/valid questionnaire. These data were collected at baseline and at 4 and 12 months postintervention. Process measures, collected via focus groups with parents, evaluated parent/community involvement.
RESULTS: At the 12-month follow-up, children in the intervention group decreased their BMI on average by 2.80 (p = 0.04) and BMI z-scores on average by 0.48 (p = 0.03) and they increased their daily dietary intake of vegetables on average by 1.51 (p = 0.03), fruit on average by 2.00 (P = 0.001), and 100% fruit juice by 1.12 (p = 0.05). An increase of 1.02 (p = 0.03) was seen in self-efficacy of healthy food choices (p = 0.03). Parent (P = 0.04) and community (p = 0.001) involvement significantly increased to 100% participation by the 12-month follow-up.
CONCLUSIONS: A CSHP using parent and community involvement was effective in reducing the risk of obesity in school-aged Mexican- American children attending low-income schools. The findings need to be examined in a larger, more diverse sample of children.
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July 24, 2012 4:00AM
BACKGROUND: Little is known about family members' interrelated decisions to seek genetic testing for breast cancer susceptibility.
METHODS: The specific aims of this cross-sectional, descriptive, cohort study were (i) to examine whether individual and family characteristics have a direct effect on women's decisions to use genetic testing for hereditary susceptibility to breast cancer and (ii) to explore whether family characteristics moderate the relationships between individual characteristics and the decision to use genetic testing. Participants were women (>18 years old) who (i) received genetic testing for hereditary breast cancer and who agreed to invite one of their female relatives into the study and (ii) female relatives who had NOT obtained genetic testing and were identified by pedigree analysis as having >10% chances of hereditary susceptibility to breast cancer.
RESULTS: The final sample consisted of 168 English-speaking, family dyads who completed self-administered, mailed surveys with validated instruments. Multivariate conditional logistic regression analyses showed that the proposed model explained 62% of the variance in genetic testing. The factors most significantly associated with genetic testing were having a personal history of cancer; perceiving genetic testing to have more benefits than barriers; having greater family hardiness; and perceiving fewer negative consequences associated with a breast cancer diagnosis. No significant interaction effects were observed.
CONCLUSIONS: Findings suggest that both individual and family characteristics are associated with the decision to obtain genetic testing for hereditary breast cancer; hence, there is a need for interventions that foster a supportive family environment for patients and their high-risk relatives.
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July 18, 2012 4:00AM
The purpose of this study was to develop and pilot test nutrition and physical activity educational tools for immigrant Latina women who have type 2 diabetes and low health literacy levels. Participants' ability to use the tools was assessed and a focus group was conducted (n=26). During two classes, the women were taught diabetes concepts related to nutrition and physical activity and were given a pedometer. The women recorded in a log vegetables consumed and steps taken. Nearly all participants (n=24) completed the nutrition log, and most used the pedometer (n=25) and completed the step log for 5 or more days (n=19). The women reported that the pedometer and logs helped them increase vegetable consumption and physical activity. Interventions for this population should use plain language, tools that are easy to use, and strategies that encourage behavioral change.
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July 9, 2012 4:00AM
In the last decade the US federal government proposed a transformation vision of mental health service delivery; patient-centered, evidence-based and recovery oriented treatment models. Health care reform brings additional expectations for innovation in mental/substance use service delivery, particularly the idea of creating systems where physical health, mental health and substance use treatment is fully integrated. Psychiatric nurses, as one of the four core US mental health professions, have the potential to play a significant role in the both the transformation initiative and health care reform vision. However, psychiatric nurses, particularly advanced practice psychiatric nurses, are an untapped resource due in part to significant state regulatory barriers that limit their scope of practice in many states. The purpose of this paper is to document what is currently known about advanced practice psychiatric nurses and discuss policy implications for tapping into the strengths of this workforce. Strategies for facilitating utilization of advanced practice psychiatric nurses discussed.
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July 2, 2012 4:00AM
The selection of methods that purposefully reflect the norms of the target population increases the likelihood of effective recruitment, data collection, and retention. In the case of research among college students, researchers' appreciation of college student norms might be skewed by unappreciated generational and developmental differences. Our purpose in this article is to illustrate how attention to the generational and developmental characteristics of college students enhanced the methods of the Risk, Religiosity, and Emerging Adulthood study. We address the following challenges related to research with college students: recruitment, communication, data collection, and retention. Solutions incorporating Internet-based applications (e.g., Facebook) and sensitivity to the generational norms of participants (e.g., multiple means of communication) are described in detail.
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July 1, 2012 4:00AM
While partner violence and sexual assault are public health concerns affecting college women, most young women do not seek help after the experience. Limited research explores the interpersonal context of help seeking related to violence in young women. The overall purpose of this research was to understand peer factors within a campus culture associated with seeking help in response to violence within a campus environment. Eight focus groups were held with 64 participants representing a broad spectrum of diversity in race and ethnicity. Narrative analysis was the primary method of analysis. Three themes emerged from the data: victim blaming, fear of direct response, and the alcohol factor. The young women's stories demonstrate the effects of friends and campus culture on perceptions of violence and abuse and help seeking. Findings suggest that peers and the social norms of the campus environment influence help-seeking behavior. An understanding of interpersonal level determinants of help seeking is essential for clinically relevant and effective prevention efforts. Nurse practitioners in campus health settings can use this research to guide assessment, intervention, and prevention strategies.
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July 1, 2012 4:00AM
This article proposes an innovative, theoretically-driven intervention to reduce risk from human papillomavirus (HPV). This lessening of HPV risk would lead to a reduction in the rate of cervical cancer. Aims of this article are to introduce a culturally appropriate model (PEN-3) that may facilitate vaccine uptake among vulnerable populations and to ascertain whether culturally appropriate health education delivered by nurses could be included in vaccine education programs.
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June 10, 2012 4:00AM
Over the last decade, new information about human papillomavirus infection has increased the healthcare community's understanding of the natural history of the disease and cervical cancer. Advances in screening, management, and diagnosis continue to refine clinicians' efforts to prevent cervical cancer in adolescent females.
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May 30, 2012 4:00AM
Although many programs aim to help older adults age in place, few target both the home environment and individual physical function. We present an interprofessional intervention called CAPABLE-Community Aging in Place: Advancing Better Living for Elders. CAPABLE's innovative approach incorporates a nurse, occupational therapist (OT), and handyman to address both individual and environmental factors that contribute to disability. The nurse component of CAPABLE addresses key barriers to functional independence such as pain, depression, strength and balance, medication management, and poor communication with the primary care provider. This article focuses primarily on the nursing aspect of the intervention and how it interrelates with the content and processes of the OT and handyman.
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May 24, 2012 4:00AM
Background: South Asian Immigrants (SAIs) are the second fastest growing Asian immigrant population in the US, and at a higher risk of type 2 diabetes (diabetes) than the general US population. Coronary Artery Disease (CAD) is the principal cause of mortality globally, particularly in diabetic subjects. In this study, we sought to determine the; 1) distribution of risk factors for CAD in diabetic and non-diabetic SAIs; and 2) presence of sub-clinical CAD in diabetic and non diabetic SAIs in the US. Methods: 213 first generation SAIs subjects were recruited and broadly divided into two subgroups; 35 diabetics and 178 non diabetics. Their risk factors for CAD were compared. For sub-clinical CAD assessment, Common Carotid Artery Intima-Media Thickness (CCA-IMT) was used as a surrogate marker for atherosclerosis. For CAD diagnosis, Exercise Tolerance stress Test (ETT) was performed. Results: Both diabetics and non diabetics SAIs in general, share a very heavy burden of CAD risk factors. Hypertension (p=0.003), high cholesterol (p<0.0001) and family history of diabetes (p<0.0001) was significantly associated with diabetes. Presence of sub-clinical CAD was also higher in diabetics as compared to non diabetics (63% Vs 52%). 45% of diabetics (who were not previously diagnosed with CAD) were found to be ETT positive for CAD (p<0.0001). Conclusion: CAD risk factors and sub-clinical CAD are more prevalent amongst diabetic SAIs. Early screening and aggressive treatment for risk factor reduction in SAIs is the key to combating the increasing incidence of CAD. Larger prospective trials are required to confirm these study findings.