Publications

Publications

Addressing a Critical Gap in U.S. National Teen Pregnancy Prevention Programs: The Acceptability and Feasibility of Father-Based Sexual and Reproductive Health Interventions for Latino Adolescent Males

Guilamo-Ramos, V., Bowman, A. S., Santa Maria, D., Kabemba, F., & Geronimo, Y. (2018). Journal of Adolescent Health, 62(3), S72-S80. 10.1016/j.jadohealth.2017.08.015
Abstract
Purpose: The purpose of the research was to examine the feasibility and acceptability of a father-based sexual and reproductive health intervention designed to reduce sexual and reproductive (SRH) disparities and increase correct and consistent condom use among Latino adolescent males. Methods: The current study conducted in-depth semi-structured interviews with Latino father-son dyads (N=30) designed to elicit perspectives on communication regarding sex and condom use. In addition, the interview protocol included father-son preferences regarding paternal involvement in condom instruction and perceived obstacles and advantages of father direct involvement in education efforts designed to increase correct and consistent condom use among their adolescent sons. Three independent coders conducted both vertical and horizontal analyses of the data to identify emergent themes and reach theoretical saturation. Results: The main findings from this study suggest that Latino fathers can be impactful in shaping Latino adolescent male sexual decision-making and correct and consistent condom use. However, our data highlight that while both feasible and acceptable, Latino fathers identify needing additional support in how best to communicate and seek opportunities to master their own knowledge and skills regarding condom use and effective communication with their adolescent sons about sex. Conclusions: Latino father-based interventions represent an acceptable and feasible option for building upon the recent success of U.S. national efforts to reduce teen pregnancy rates and STI disparities among Latino youth. However, there exists a need for father-based programs that will support Latino fathers in best educating their sons about condom use and better addressing their SRH. Ongoing national efforts to reduce Latino teen SRH disparities warrant the consideration of father-son interventions for Latino adolescent males in the United States.

Addressing the Social Determinants of Health: A Call to Action for School Nurses

Schroeder, K., Malone, S. K., McCabe, E., & Lipman, T. (2018). Journal of School Nursing, 34(3), 182-191. 10.1177/1059840517750733
Abstract
Social determinants of health (SDOH), the conditions in which children are born, grow, live, work or attend school, and age, impact child health and contribute to health disparities. School nurses must consider these factors as part of their clinical practice because they significantly and directly influence child well-being. We provide clinical guidance for addressing the SDOH when caring for children with three common health problems (obesity, insufficient sleep, and asthma). Given their unique role as school-based clinical experts, care coordinators, and student advocates, school nurses are well suited to serve as leaders in addressing SDOH.

Aging and Global Health

Wu, B., & Feng, Y. (2018). People’s Medical Publishing House.

Aging and Long-term Care

Wu, B., & Peng, R. (2018). In Aging and Global Health (pp. 149-165). People’s Medical Publishing House.

An assistive technology system that provides personalized dressing support for people living with dementia: Capability study

Burleson, W., Lozano, C., Ravishankar, V., Lee, J., & Mahoney, D. (2018). Journal of Medical Internet Research, 20(5). 10.2196/medinform.5587
Abstract
Background: Individuals living with advancing stages of dementia (persons with dementia, PWDs) or other cognitive disorders do not have the luxury of remembering how to perform basic day-to-day activities, which in turn makes them increasingly dependent on the assistance of caregivers. Dressing is one of the most common and stressful activities provided by caregivers because of its complexity and privacy challenges posed during the process. Objective: In preparation for in-home trials with PWDs, the aim of this study was to develop and evaluate a prototype intelligent system, the DRESS prototype, to assess its ability to provide automated assistance with dressing that can afford independence and privacy to individual PWDs and potentially provide additional freedom to their caregivers (family members and professionals). Methods: This laboratory study evaluated the DRESS prototype's capacity to detect dressing events. These events were engaged in by 11 healthy participants simulating common correct and incorrect dressing scenarios. The events ranged from donning a shirt and pants inside out or backwards to partial dressing-typical issues that challenge a PWD and their caregivers. Results: A set of expected detections for correct dressing was prepared via video analysis of all participants' dressing behaviors. In the initial phases of donning either shirts or pants, the DRESS prototype missed only 4 out of 388 expected detections. The prototype's ability to recognize other missing detections varied across conditions. There were also some unexpected detections such as detection of the inside of a shirt as it was being put on. Throughout the study, detection of dressing events was adversely affected by the relatively smaller effective size of the markers at greater distances. Although the DRESS prototype incorrectly identified 10 of 22 cases for shirts, the prototype preformed significantly better for pants, incorrectly identifying only 5 of 22 cases. Further analyses identified opportunities to improve the DRESS prototype's reliability, including increasing the size of markers, minimizing garment folding or occlusions, and optimal positioning of participants with respect to the DRESS prototype. Conclusions: This study demonstrates the ability to detect clothing orientation and position and infer current state of dressing using a combination of sensors, intelligent software, and barcode tracking. With improvements identified by this study, the DRESS prototype has the potential to provide a viable option to provide automated dressing support to assist PWDs in maintaining their independence and privacy, while potentially providing their caregivers with the much-needed respite.

The association between nurse shift patterns and nurse-nurse and nurse-physician collaboration in acute care hospital units

Ma, C., & Stimpfel, A. W. (2018). Journal of Nursing Administration, 48(6), 335-341. 10.1097/NNA.0000000000000624
Abstract
OBJECTIVE The aim of this study was to examine the impact of nurse shift patterns on nurses' collaboration with nurses and physicians in US acute care hospital units. BACKGROUND Collaboration between nurses and other healthcare providers is critical for ensuring quality patient care. Nurses perform collaboration during their shift work; thus, nurse shift patterns may influence collaboration. However, there is a dearth of empirical evidence of the relationship between nurse shift patterns and collaboration of nurses with other healthcare providers. METHODS This is a cross-sectional study using data from 957 units in 168 acute care hospitals. Measures of collaboration include nurse-nurse collaboration and nurse-physician collaboration. Measures of shift patterns included shift length and overtime. Multilevel linear regressions were conducted at the unit level, controlling unit and hospital characteristics. RESULTS Overtime (more nurses working overtime or longer overtime hours) was associated with lower collaboration at the unit level; however, shift length was not. CONCLUSIONS Working overtime may negatively influence nurses' collaboration with other healthcare providers.

Associations Between Acculturation and Oral Health Among Older Chinese Immigrants in the United States

Ge, S., Wu, B., & Dong, X. (2018). Gerontology and Geriatric Medicine, 4(1).
Abstract
Background: The aim of this study was to understand the associations between acculturation and oral health among older Chinese immigrants in the United States. Method: We used data from the PINE study, which included the foreign-born older Chinese immigrants (N = 3,128). We measured acculturation by measuring participants’ length of stay and behavioral acculturation. Participants’ tooth and gum symptoms were the outcome variables. Results: Longer stay in the United States was significantly associated with fewer gum symptoms but not with tooth symptoms. Behavioral acculturation was not significantly associated with either tooth or gum symptoms. The middle tertile of behavioral acculturation, compared with its upper and lower tertiles, deemed to be a more significant risk factor of tooth/gum symptoms. In addition, older immigrants with more social interactions with the Americans were more likely to have tooth symptoms. Discussion: In the future, we will conduct a study using longitudinal data to help us better understand the relationship between acculturation and oral health in Chinese American population.

Cardiovascular Disease Risk in Sexual Minority Women (18-59 Years Old): Findings from the National Health and Nutrition Examination Survey (2001-2012)

Caceres, B. A., Brody, A. A., Halkitis, P. N., Dorsen, C., Yu, G., & Chyun, D. A. (2018). Women’s Health Issues. 10.1016/j.whi.2018.03.004
Abstract
Objective: Sexual minority women (lesbian and bisexual) experience significant stigma, which may increase their cardiovascular disease (CVD) risk. The purpose of this study was to examine the prevalence of modifiable risk factors for CVD (including mental distress, health behaviors, blood pressure, glycosylated hemoglobin, and total cholesterol) and CVD in sexual minority women compared with their heterosexual peers. Materials and Methods: A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation with chained equations was performed. Logistic regression models adjusted for relevant covariates were run. Self-report (medical history and medication use) and biomarkers for hypertension, diabetes, and high total cholesterol were examined. Results: The final analytic sample consisted of 7,503 that included 346 sexual minority women (4.6%). Sexual minority women were more likely to be younger, single, have a lower income, and lack health insurance. After covariate adjustment, sexual minority women exhibited excess CVD risk related to higher rates of frequent mental distress (adjusted odds ratio [AOR], 2.05; 95% confidence interval [CI], 1.45–2.88), current tobacco use (AOR, 2.11; 95% CI, 1.53–2.91), and binge drinking (AOR, 1.66; 95% CI, 1.17–2.34). Sexual minority women were more likely to be obese (AOR, 1.61; 95% CI, 1.23–2.33) and have glycosylated hemoglobin consistent with prediabetes (AOR, 1.56; 95% CI, 1.04–2.34). No differences were observed for other outcomes. Conclusions: Sexual minority women demonstrated increased modifiable risk factors for CVD, but no difference in CVD diagnoses. Several emerging areas of research are highlighted, in particular, the need for CVD prevention efforts that target modifiable CVD risk in sexual minority women.

Ceremonial ‘Plant Medicine’ use and its relationship to recreational drug use: an exploratory study

Dorsen, C., Palamar, J., & Shedlin, M. G. (2018). Addiction Research and Theory, 1-8. 10.1080/16066359.2018.1455187
Abstract
Background: The ceremonial use of psychoactive/hallucinogenic plant based drugs, such as ayahuasca, psilocybin and others, is a growing trend in the United States (US) and globally. To date, there has been little research documenting how many people are using psychoactive substances in this context, who the users are, what benefits/risks exist in the use of these drugs and the relationship between ceremonial drug use and recreational drug use. In this paper we describe a cohort of plant medicine facilitators in the US and explore how they differentiate plant medicine use from recreational drug use. Methods: Using modified ethnography, individual interviews were conducted in 2016 with 15 participants who are currently facilitating plant medicine ceremonies in the US. Descriptive content analysis was performed to discover themes and to inform a larger mixed-method study. Results: Ceremonial drug use was seen by participants as a natural healing and treatment modality used in the context of community and ritual. Three main themes were identified relating to participants’ differentiation between ceremonial plant medicine use and recreational drug use: (1) participants see a clear delineation between plant medicine use and recreational drug use; (2) plant medicine is seen as a potential treatment for addiction, but concerns exist regarding potential interference with recovery; and (3) plant medicine use may influence recreational use. Conclusions: More research is needed on who is using plant medicine, motivators for use, perceived and real risks and benefits of plant medicine use and harm reduction techniques regarding safe ingestion.

Collecting Mobility Data with GPS Methods to Understand the HIV Environmental Riskscape Among Young Black Men Who Have Sex with Men: A Multi-city Feasibility Study in the Deep South

Duncan, D. T., Chaix, B., Regan, S. D., Park, S. H., Draper, C., Goedel, W. C., Gipson, J. A., Guilamo-Ramos, V., Halkitis, P. N., Brewer, R., & Hickson, D. M. (2018). AIDS and Behavior, 1-14. 10.1007/s10461-018-2163-9
Abstract
While research increasingly studies how neighborhood contexts influence HIV among gay, bisexual and other men who have sex with men (MSM) populations, to date, no research has used global positioning system (GPS) devices, an innovative method to study spatial mobility through neighborhood contexts, i.e., the environmental riskscape, among a sample of Black MSM. The purpose of this study was to examine the feasibility of collecting two-week GPS data (as measured by a pre- and post-surveys as well as objectively measured adherence to GPS protocol) among a geographically-diverse sample of Black MSM in the Deep South: Gulfport, MS, Jackson, MS, and New Orleans LA (n = 75). GPS feasibility was demonstrated including from survey items, e.g. Black MSM reported high ratings of pre-protocol acceptability, ease of use, and low levels of wear-related concerns. Findings from this study demonstrate that using GPS methods is acceptable and feasible among Black MSM in the Deep South.

Content validation of the Arabic translation of the Practice Environment Scale of the Nursing Work Index

Ambani, Z., Al-Hamdan, Z., Al-Touby, S., Ghanim, A., Al Jarameez, F., & Squires, A. (2018). Journal of Nursing Measurement.

Contributory behaviors and life satisfaction among Chinese older adults: Exploring variations by gender and living arrangements

Liu, S., Zhang, W., Wu, L. H., & Wu, B. (2018). Social Science and Medicine. 10.1016/j.socscimed.2018.06.015
Abstract
The rapid population aging taking place in China makes studies tackling opportunities associated with aging an urgent priority. Based on the productive aging perspective, this study examines the relationship between contributory behaviors (i.e., providing economic, housework, and emotional support to adult children and providing care for grandchildren) and life satisfaction, as well as how gender and living arrangements modify the relationship. Using data collected from 809 older adults in Wuhan, China, and applying ordinary least squares regressions, this study found that engaging in contributory behaviors in general, and providing emotional support to adult children and caring for grandchildren in particular, are associated with enhanced life satisfaction. The association between caring for grandchildren and life satisfaction is only salient for males but not for females. For living arrangements, the positive association between engaging in contributory behaviors and life satisfaction is only identified among older adults living with their spouse and other family members. The positive association of providing emotional support to adult children with life satisfaction is significant for older adults living with their spouse only. Finally, frequently taking care of grandchildren is related positively to life satisfaction among those living with both spouse and other family members. Our findings provide empirical evidence suggesting that Chinese older adults are still very active in providing support to family members and highlight the beneficial effects of contributory behaviors on individual's life satisfaction. For policy makers, it is important to continuously promote values of contributing behaviors to family and take into account the importance of family ties and family support to older adults when designing new elder care programs.

Cultural competence and psychological empowerment among acute care nurses

Ea, E., & Gilles, S. (2018). In Nursing research critique: A model for excellence. Springer.

Defining Successful Aging: Perceptions From Elderly Chinese in Hawai‘i

Zhang, W., Liu, S., & Wu, B. (2018). Gerontology and Geriatric Medicine, 4(1).
Abstract
Background: This study aims to examine the lay perceptions of successful aging among elderly Chinese in Hawai‘i, the state has the highest life expectancy in the United States. Method: Principal components factor analysis and logistic regression models were used to analyze survey data collected among 136 respondents who were asked to evaluate the importance of 12 successful aging items developed in Asian societies involving the Chinese population. Results: Results from factor analysis reveal three distinct factors out of the 12 items of successful aging—(a) psychosocial and economic well-being, (b) physical well-being, and (c) social support from adult children. The former two factors were perceived as important dimensions of successful aging by most survey participants, and approximately 35%-41% respondents viewed items composing Factor 3 as important. Discussion: Results suggest that elderly Chinese in Hawai‘i have unique perceptions of successful aging that go beyond the Rowe and Kahn’s biomedical model to include more psychosocial components. In addition, their perceptions are similar to but slightly different from perceptions of elderly Chinese in China and Singapore in levels of familism. Our findings indicate cultural variation of successful aging.

Delivering LGBTQ-sensitive care

Lim, F., Paguirigan, M., & Cernivani, D. (2018). Nursing Critical Care, 13(4), 14-19. 10.1097/01.CCN.0000534918.70677.9c
Abstract
Members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community have historically faced prejudices, often resulting in significant health disparities. Critical care nurses have a duty to provide all patients, regardless of their sexual orientation or gender identity, with the best possible care. This article examines a framework for LGBTQ-sensitive care as well as best practices and additional resources.

Dementia Caregiver Interventions in Chinese Population: A Systematic Review

Wu, B., Petrovsky , D. V., Wang, J., Xu, H., Zheng, Z., McConnell, E. S., & Corazzini, K. (2018). Journal of Advanced Nursing. 10.1111/jan.13865
Abstract
AimsThe aim of this systematic review was to examine the characteristics and efficacy of dementia caregiving interventions among the Chinese population.BackgroundIn recent years, an increasing number of dementia caregiving interventions have been developed for Chinese older adults living in Asia that aim to reduce caregivers’ burden, depression and distress and enhance quality of life. Little is known, however, on the nature and the efficacy of these interventions.DesignSystematic review with narrative summary.Data SourcesWe searched four databases for studies published in English between 1 January 1994 ‐ 30 December 2017. Nineteen studies reported in twenty‐three articles were included in the final analysis.Review MethodsWe used a set of criteria from the Cochrane Collaboration tool to assess for the risk of bias across studies.ResultsWe found that interventions varied in length, frequency, approach and content, making comparisons across studies challenging. Caregivers’ burden, depression and distress were improved among most included studies. All studies that examined quality of life of caregivers (N=6) showed improvement. Most of the interventions showed beneficial effects on care recipients’ behavioral symptoms, agitation and depression; cognitive function, however, failed to improve.ConclusionAlthough the review found mixed results on intervention outcomes, the majority of interventions showed a potential to improve the health and well‐being of dementia caregivers and care recipients. This review provides suggestions for future dementia caregiving research in the Chinese population, such as inclusion of relevant theoretical frameworks and more rigorous research designs.This article is protected by copyright. All rights reserved.

Discussing the nuances of sexual health with patients

Newland, J. A. (2018). Nurse Practitioner, 43(9). 10.1097/01.NPR.0000544283.12633.b0

Does Oral Health Predict Functional Status in Late Life? Findings From a National Sample

Zhang, W., Wu, Y. Y., & Wu, B. (2018). Journal of Aging and Health, 30(6), 924-944. 10.1177/0898264317698552
Abstract
Objective: This study aims to examine the association between oral health and the decline in functional status among middle-aged and older adults in the United States. Method: Generalized estimation equation (GEE) Poisson regression models with robust standard errors were used to analyze the longitudinal panel data (2008-2014) from the Health and Retirement Study (N = 1,243). Oral health was evaluated using self-rated oral health, poor mouth condition, and tooth loss. Decline in functional status was assessed by disabilities in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Results: Respondents with poor oral health were more likely to experience decline in ADLs/IADLs. Adjusting for sociodemographics and comorbidities attenuated the effects of oral health. Discussion: Findings suggest that oral health might be one of the important predictors of functioning decline in late life, after adjusting sociodemographics and comorbidities.

An educational intervention to evaluate nurses’ knowledge of heart failure

Sundel, S., & Ea, E. E. (2018). Journal of Continuing Education in Nursing, 49(7), 315-321. 10.3928/00220124-20180613-07
Abstract
Background: Nurses are the main providers of patient education in inpatient and outpatient settings. Unfortunately, nurses may lack knowledge of chronic medical conditions, such as heart failure. Method: The purpose of this one-group pretest– posttest intervention was to determine the effectiveness of teaching intervention on nurses’ knowledge of heart failure self-care principles in an ambulatory care setting. The sample consisted of 40 staff nurses in ambulatory care. Nurse participants received a focused education intervention based on knowledge deficits revealed in the pretest and were then resurveyed within 30 days. Nurses were evaluated using the valid and reliable 20-item Nurses Knowledge of Heart Failure Education Principles Survey tool. Results: The results of this project demonstrated that an education intervention on heart failure self-care principles improved nurses’ knowledge of heart failure in an ambulatory care setting, which was statistically significant (p, .05). Conclusion: Results suggest that a teaching intervention could improve knowledge of heart failure, which could lead to better patient education and could reduce patient readmission for heart failure.

End-of-Life Care Preference: Examination of Chinese Adults with Children and Those Who Lost Their Only Child

Liang, Y., Cui, H. L., Wang, J., Xu, H., & Wu, B. (2018). Journal of Palliative Medicine.
Abstract
Background: Little is known about the end-of-life (EOL) care preference and its associated factors among community-dwelling adults in Mainland China. This study investigated the EOL care preference and its associated factors among community-dwelling Chinese adults in Shanghai, China.Methods: A cross-sectional survey was conducted in Shanghai, China, from April to June in 2013. A total of 1200 older adults aged 60 years and older and another 200 middle-aged and older adults aged 45 years and older who lost their only child were included in the current study. In the current study, the EOL care preference included three categories: preferred family care, preferred care provided by visiting healthcare professionals, and preferred care in a specialized EOL care institute. Childlessness was coded as lost the only child, had children but not coresiding, and had coresiding children. Mor and Hiris's model of choices of setting at the EOL was used to explore the EOL care preference and its associated factors, including sociodemographic characteristics, support networks, functional characteristics, and healthcare system. Multinomial logistic regressions were used to estimate the factors associated with their EOL care preference.Results: In terms of EOL care preference, adults who lost their only child preferred care provided by a specialized EOL care institute (58.43%), while adults who had children preferred family care at home (46.72% for adults who did not coreside with children and 49.04% for those who did). Results from multinomial logistic regressions showed that adults with higher income, having properties, and having children tended to opt for family care at home. Participants with friends' support preferred EOL care provided by visiting healthcare professionals or specialized EOL care institutions over family care at home.Conclusions: Income, wealth, having children, and having friends' support were significant factors that were associated with the EOL care preference among Chinese adults. Home-based EOL care, professional and individualized hospice, or palliative care provided by institutions need to be developed in China.

The experience of being aware of disease status in women with recurrent ovarian cancer: A phenomenological study

Finlayson, C. S., Appelbaum, A., Squires, A., & Fu, M. (2018). Journal of Palliative Medicine.

Factors Associated With HIV Testing in U.S. Latinos When Language Preference is Spanish

Juarez-Cuellar, A., & Squires, A. (2018). Journal of the Association of Nurses in AIDS Care, 29(1), 120-25. 10.1016/j.jana.2017.11.001

Faculty and Student Perspectives on Mentorship in a Nursing Honors Program

Nelson, N., Lim, F., Margaret-Navarra, A., Rodriguez, K., Witkoski, A., & Slater, L. Z. (2018). Nursing Education Perspectives, 39(1), 29-31. 10.1097/01.NEP.0000000000000197
Abstract
Honors programs in nursing can facilitate the professional development of high-achieving students, supporting their lifelong engagement in nursing practice, education, research, and health care policy issues. Strong mentoring relationships are commonly identified as essential to the success of nursing honors programs, but literature on mentoring relationships in an honors context is limited. The purpose of this study was to gain insight into faculty and student expectations for mentorship. Faculty and students shared similar expectations for both the mentor and mentee, highlighting key themes of engagement, facilitation, accountability, and collaboration as necessary for the success of an undergraduate nursing honors program.

Feasibility and Efficacy of a Student Nurse Delivered, Parent-Based Sexual Health Curriculum in Underserved Communities: A Pilot Randomized Controlled Trial

Santa Maria, D., Reagan, E., Markham, C., Guilamo, V., & Cron, S. (2018). Pediatric Nursing.

A Framework for Integrating Oncology Palliative Care in Doctor of Nursing Practice (DNP) Education

Fennimore, L., Wholihan, D., Breakwell, S., Malloy, P., Virani, R., & Ferrell, B. (2018). Journal of Professional Nursing. 10.1016/j.profnurs.2018.09.003
Abstract
Doctor of Nursing Practice (DNP) faculty play a critical role in preparing students to meet the complex needs of the nation as the number of cancer rates and survivors rise (National Cancer Institute, 2018) and as an unprecedented number of older Americans enter into the healthcare system with complicated comorbidities (Whitehead, 2016). Palliative care has dramatically expanded over the past decade and has been increasingly accepted as a standard of care for people with cancer and other serious, chronic, or life-limiting illnesses. Advanced practice registered nurses (APRNs) are recognized as important providers of palliative care (Walling et al., 2017). A 2-day course was held with support from the National Cancer Institute to enhance integration of palliative oncology care into DNP curriculum. The course participants (N = 183), consisting of DNP faculty or deans, practicing DNP clinicians, and students, received detailed annotated slides, case studies, and suggested activities to increase student engagement with the learning process. Course content was developed and delivered by palliative care experts and DNP faculty skilled in curriculum design. Participants were required to develop goals on how to enhance their school's DNP curriculum with the course content. They provided updates regarding their progress at integrating the content into their school's curriculum at 6, 12, and 18 months post course. Results demonstrated an increase in incorporating oncology palliative care in DNP scholarly projects and clinical opportunities. Challenges to inclusion of this content in DNP curricula included lack of: perceived time in curriculum; faculty educated in palliative care; and available clinical sites.