Public Health Nursing最新文献

Background: Older adult immigrants are a growing population in the United States. While many are Spanish-speaking, there are thousands of Russian-speaking immigrants who immigrated after the Soviet Union dissolved. This study aims to enhance the understanding of older adult Russian- and Spanish-speaking (im)migrants experiences regarding health, health-seeking behavior, healthcare expectations, and the healthcare system.

Methods: Utilizing a community-engaged and participatory research approach, this project developed through multiyear relationships with nonprofit organizations and community stakeholders. The goal of this project, conducted using a Qualitative-Narrative Inquiry-Photovoice methodology, focusing on Spanish- and Russian-speaking (im)migrants in Southeastern, Wisconsin, was to better understand the experiences and stories of older adult immigrants regarding healthcare access.

Results: Main themes were as follows: (1) "Whom can I trust if not my son?" (information sources), (2) "You're already old, you're already sick" (when and why medical care is desired), and (3) "You die or you get better" (access issues). The findings illustrate challenges accessing healthcare and differing medical expectations.

Conclusions: Training on health communication and sensitivity to different groups is crucial for professionals. These findings have implications for training future health professionals and structuring healthcare systems.

Objective: Timely follow-up after community-based screening is critical for managing non-communicable diseases (NCDs). In Indonesia, Pos Pembinaan Terpadu (Posbindu) provides grassroots-level screening for hypertension and diabetes. This study examined sociodemographic factors associated with whether screened individuals completed follow-up at primary healthcare facilities.

Design, sample, measurements: A cross-sectional analysis was conducted among 277 adults identified with hypertension and/or elevated glucose during Posbindu screening in Aceh Besar, Indonesia. All were referred to a primary healthcare facility (Puskesmas) for clinical confirmation. Sociodemographic data were collected via questionnaire. A penalized logistic regression analysis was used to identify independent predictors of follow-up.

Results: Following the screening, less than half of participants (42.2%) completed follow-up. Older age was associated with a higher likelihood of follow-up attendance (AOR = 1.17 per year, 95% CI: 1.13-1.22), and females were more likely to attend follow-up than males (AOR = 3.00, 95% CI: 1.28-7.02). In contrast, being employed (AOR = 0.22, 95% CI: 0.11-0.44) and not being married (AOR = 0.39, 95% CI: 0.18-0.84) were associated with lower follow-up attendance.

Conclusions: Less than half of referrals completed care. Age, gender, marital status, and employment were key determinants of follow-up attendance, highlighting the need for targeted interventions to strengthen continuity of care after community-based screening.

Trial registration: This study was a cross-sectional observational study and was not registered as a clinical trial.

Objectives: This study aims to evaluate a dual approach to reduce blood pressure among patients at a Community Health Center in the Southeast through telephonic outreach and skill-based self-management classes.

Methods: A pre-post single cohort design was implemented over five months. Trained ambassadors conducted telephone outreach to invite Black adults with uncontrolled hypertension (systolic > 160 mmHg and/or diastolic > 100 mmHg) to participate in group classes focusing on skill-based blood pressure self-monitoring and health education. Patient-reported class interest, blood pressure, and class attendance were recorded. Paired t-tests were used to analyze BP changes before and after the intervention.

Results: Of 291 patients called, 149 (51.2%) engaged with the caller, 71 (47.7%) expressed interest in classes, and 24 (16.1%) attended class. After outreach, reductions in blood pressure (systolic: 170.47 mmHg to 139.94 mmHg, p < 0.001; diastolic: 97.15 mmHg to 83.21 mmHg, p < 0.001) were observed. Among those attending the first class, 75% did not own a blood pressure monitor.

Conclusions: A dual approach using telephonic outreach and self-monitoring skill acquisition was associated with reduced blood pressure, but barriers to in-person attendance persist. Providing blood pressure monitors and digital education resources could enhance outcomes for high-risk Black patients.

Purpose: The study aims to evaluate the effectiveness of a multisensory educational intervention using visual and kinesthetic methods to improve attitudes, health beliefs, and perceived benefits, while reducing barriers to colorectal cancer screening in individuals aged 50 and older.

Methods: The study employed a pretest and posttest randomized controlled trial design. Both the intervention and control groups completed the Attitudes Toward Cancer Screening Scale, the Health Belief Model Scale for the Prevention of Colorectal Cancer, and the Perceived Benefits and Barriers Scale for Colorectal Cancer Screening Behaviors at the study's outset and again two weeks after the intervention concluded. Adults aged 50 years and older who were registered at the selected family healthcare centers were invited to participate in the study.

Findings: The intervention group scored significantly higher on the Attitude Scale for Cancer Screening and the Confidence/Benefits subscale, indicating improved positive attitudes. They scored lower in Susceptibility, Barriers, and Health Motivation and had better perceptions of the benefits of the fecal occult blood test than the control group.

Conclusions: This study employed a multi-sensory approach to improve attitudes and beliefs toward colorectal cancer screening, aiming to facilitate positive behavioral changes and reduce barriers to screening.

Background: This study aims to determine the relationship between problematic social media usage, addiction to mindful eating, digital nutrition, and health literacy among adults.

Study design: Cross-sectional study.

Methods: The study involved 405 participants (154 men, 251 women) aged between 18 and 60. The participants were administered a questionnaire package involving demographic information sheet, anthropometric measurements, Mindful Eating Questionnaire (MEQ), Health Literacy Index (HLI), Digital Healthy Diet Literacy (DHDL), and Social Media Addiction Form (SMAS).

Results: Women scored 2.2 ± 0.34 on the MEQ, 102.5 ± 16.41 on the HLI, 21.4 ± 11.95 on the DHDL, and 2.2 ± 0.71 on the SMAS. Men scored 2.3 ± 0.34, 100.8 ± 14.69, 21.1 ± 11.89, 2.6 ± 2.49, respectively. Significant correlations were found between problematic social media use and education level, and employment status (p < 0.05). There was a positive correlation between problematic social media use and mindful eating, while a negative relationship was found between problematic social media use and health literacy (p < 0.05). There was a significant negative relationship between health literacy and mindful eating, and a significant positive relationship between health literacy and digital nutrition literacy (p < 0.05).

Conclusions: Problematic social media usage has an impact on mindful eating, health literacy, and nutrition literacy. Improving health literacy could reduce problematic social media use by enabling individuals to benefit from health information better. Exposure to unverified diet trends on Instagram, on social media, might prevent the beneficial use of the platforms.

Objective: 1,4-Dioxane (DX), a synthetic organic chemical solvent prevalent in water systems, has been monitored by the U.S. Environmental Protection Agency (EPA) as a possible carcinogen since 2013. Delegation of risk tolerance levels to states has resulted in varying exposure standards across the U.S., concerning DX-impacted communities. This study employed a community-based participatory research (CBPR) to design a survey that identifies DX-impacted communities' concerns and preferred risk management strategies.

Methods: CBPR survey design drew on descriptions of two DX-impacted communities in Michigan and North Carolina to target key issues and outcomes. An addendum to the survey was designed to gather expert reviewer feedback and face-validate the draft survey using mixed methods. Snowball sampling increased the expert-reviewer sample size (N = 29). Targeted reliability statistics were applied to eight Likert-scale evaluation questions.

Results: Thematic scoring of responses highlighted requests for tools that may prompt timelier and more effective control of related health risks. Cronbach's alpha coefficient (0.93) showed high internal consistency regarding the respondents' expression of the validity of the survey.

Discussion: Experts supported advancing the survey's criterion testing in one DX-impacted community. This design approach may be used by public health nursing teams to amplify community voices, integrate contextual evidence with epidemiology, strengthen advocacy, and guide multisector collaboration regarding DX-related health risks.

Background: Public Health Nurses perform many of the fundamental services of tuberculosis control practices, and they ensure patients receive proper treatment, monitor their health, and work to prevent the spread of the disease through community outreach and screening. The cost of managing tuberculosis (TB) cases by Public Health Nurses (PHNs) is not well documented but is essential for performance management, quality improvement, program decision-making, and resource allocation.

Methods: We quantified the direct cost of TB nurse case management and diagnostic workup for individuals with TB using data from the Wisconsin Electronic Disease Surveillance System (WEDSS) and expense reports from local health care organizations. Costs included diagnostic and clinical expenses for each TB category.

Results: From 2012 to 2022, the average cost to diagnose and case manage latent TB infection (LTBI) was $1,956-$2,867. For pulmonary TB, costs were $12,548-$13,117; extrapulmonary TB ranged from $9,072-$9,641; and presumed TB averaged $1,721.

Conclusion: This analysis outlines the financial and staffing resources required for TB diagnosis and case management. Costs associated with LTBI are considerably lower than active TB, underscoring the value of prevention.

Background: Rural health departments face unique challenges in advancing health equity, particularly during times of political polarization. These challenges intensified during the COVID-19 pandemic, highlighting the complex interplay between public health authorities, political dynamics, and community trust.

Objective: To document how a rural local county health department (LCHD) navigated political barriers and systemic inequities to conduct a community health assessment (CHA) during and after the COVID pandemic.

Approach: This CHA, conducted during 2021-2023, employed mixed methods data collection strategies: a bilingual community survey, listening sessions in English and Spanish, and informal interviews. Utilizing a health equity lens, the analysis focused on identifying power dynamics, systemic barriers, and community perspectives on health.

Results: Survey data revealed differences between Hispanic and non-Hispanic respondents' health concerns and perceived barriers. Healthcare access was the only statistically significant barrier for Hispanic respondents. Lessons learned from the CHA process are provided.

Conclusion: The strategies employed during the CHA demonstrate how rural health departments can advance health equity while navigating complex political landscapes. Success requires careful attention to language, strategic coalition building, and persistent focus on elevating marginalized voices. The LCHD built community trust despite political resistance by modifying language around equity issues and strategic coalitions.

Objectives: This study aimed to investigate the level of fall risk perception and its influencing factors among community-dwelling older patients with stroke.

Design: A cross-sectional design.

Methods: From December 2023 to March 2024, convenience sampling was used to select participants from the community of older stroke patients who were discharged from the neurology department of two general hospitals in Wuxi City, Jiangsu Province, and returned to the home environment. Questionnaires were used to measure demographic information and disease-related details, fear of falling, fall risk perception, fall efficacy, aging attitudes, self-stereotyping of aging, social support, self-management behaviors for fall prevention, and international physical activity. Descriptive statistics, Pearson and Spearman correlation analyses, t-tests, one-way ANOVA, and multiple linear regression models were used.

Results: The score of fall risk perception of older patients with stroke in the community was 42.16 ± 11.59. Fall history, fear of falling, fall efficacy, aging attitudes, social support, and self-management behaviors for fall prevention were associated with fall risk perception.

Conclusions: The fall risk perception among community-dwelling older patients with stroke requires enhancement. Community health professionals should develop tailored intervention programs aimed at improving patients' fall risk perception.

Objectives: To understand the incidence rate of depression in disabled older adults and its influential factors in China.

Background: The increasing number of older adults with depression poses a severe public health challenge. Understanding the mental health status of disabled older adults and exploring their influencing factors as comprehensively as possible holds significant practical importance.

Methods: This study was based on data from the China Health and Retirement Longitudinal Study (CHARLS) 2020 and collected basic characteristics and information on the depression status of older adults Chinese disabled older adults aged 60 and above. Influencing factors were analyzed using binary logistic regression.

Results: Among the 2358 disabled older adults, 1504 (63.78%) had depressive symptoms, and 854 (36.22%) had no depressive symptoms. The results of binomial Logistic regression analysis showed that gender, place of residence, education and disability degree, life satisfaction, and self-rated health level were the factors affecting the occurrence of depression in disabled older adults (p < 0.05).

Conclusion: This study reveals that depression among disabled older adults in China is influenced by multiple interconnected factors. Greater attention should therefore be directed toward the mental health of this population, and targeted measures should be implemented to improve depressive conditions among disabled older adults.