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Objective Design Sample Measurements Results Conclusion This study was conducted to examine the relationship between public health nurses' holistic nursing and social justice advocacy competencies in terms of their attitudes toward sustainable development goals.Cross‐sectional survey.The study sample consisted of 384 public health nurses.Data were collected with the personal information form, the Attitudes toward Sustainable Development Scale, the Holistic Nursing Competence Scale, and the Social Justice Advocacy Scale.The sub‐dimensions of environment, public, education, and economy were found to significantly affect social justice advocacy, and the indirect effects of 0.191, 0.222, 0.205, and 0.201 were found to be statistically significant with the inclusion of holistic nursing competence in the model, respectively. It was found to explain 32%, 30%, 29%, and 22% of the total effect, respectively.It supports the claim that developing public health nurses' holistic nursing competence and social justice advocacy skills is an important criterion for achieving sustainable development goals. [ABSTRACT FROM AUTHOR]

The connection between community healthcare providers and available community‐based programs is often weak. For community members to be connected with services, a strong referral link between providers and programs is paramount. The Referral Express and Central Hub (REACH) project was born out of this need for Nurse–Family Partnership (NFP) program sites in the Denver Metro area of Colorado to be better connected and coordinated with local referral sources. The objective of the REACH pilot was to create a centralized referral system and determine its feasibility in practice. After a 12‐month pilot, this innovative referral system supported the increase in a number of referral partners to Denver Metro area sites, an increase in clients served across the Denver Metro area, as well as an increase in the "refer to enroll" rate which increased by 37%. The success of the pilot of REACH led the developers to test the process on a second program, Child First, which was also successful. REACH has proved to be sustainable and continues to operate for both programs. Additionally, REACH acts as a consultant to NFP sites outside the Denver Metro area, in the state of Colorado, as each site works to increase its relationships with referral partners. [ABSTRACT FROM AUTHOR]

Objective: To illuminate child healthcare nurses' experiences of communication with 4‐year‐old children during their visit to the child healthcare center. Design: A qualitative method, using data collected from individual interviews. Sample: Fifteen semistructured interviews with nurses working in a child healthcare center. Measurements: The results were analyzed using reflexive thematic analysis. Results: The analysis resulted in three themes and eight subthemes: Adapting to the child in the conversation, based on the subthemes Preparing for the visit, Listening in and observing, and Creating a welcoming environment; Combining strategies for the conversation, based on the subthemes Engaging the child, Using visual tools, and Parental involvement; and Challenges due to language barriers, based on the subthemes Using an interpreter and Parent acts as interpreter. Conclusion: Child healthcare nurses focus on the child when communicating and strive to create joy and a welcoming environment. The communication strategies employed during the visit include engaging the child directly, involving parents in the conversation, and balancing the parental involvement. Communication challenges related to language barriers are addressed, particularly during interpreter‐assisted conversations. The study indicates a need for tailored strategies, collaboration, and sensitivity to ensure a child‐centered approach. [ABSTRACT FROM AUTHOR]

Objectives: Women's attendance to cervical cancer screening (CCS) is a major concern for healthcare providers in community. This study aims to use the various algorithms that can accurately predict the most barriers of women for nonattendance to CS. Design: The real‐time data were collected from women presented at OPD of primary health centers (PHCs). About 1046 women's data regarding attendance and nonattendance to CCS were included. In this study, we have used three models, classification, ensemble, and deep learning models, to compare the specific accuracy and AU‐ROC for predicting non‐attenders for CC. Results: The current model employs 22 predictors, with soft voting in ensemble models showing slightly higher specificity (96%) and sensitivity (93%) than weighted averaging. Bagging excels with the highest accuracy (98.49%), specificity (97.3%), and ideal sensitivity (100%) with an AUC of 0.99. Classification models reveal Naive Bayes with higher specificity (97%) but lower sensitivity (91%) than Logistic Regression. Random Forest and Neural Network achieve the highest accuracy (98.49%), with an AUC of 0.98. In deep learning, LSTM has an accuracy of 95.68%, higher specificity (97.60%), and lower sensitivity (93.42%) compared to other models. MLP and NN showed the highest AUC values of 0.99. Conclusion: Employing ensemble and deep learning models proved most effective in predicting barriers to nonattendance in cervical screening. [ABSTRACT FROM AUTHOR]

Objectives: To clarify the conceptual structure of "cultural competence (CC)" among Japanese public health nurses (PHNs), to enhance culturally appropriate support. Methods: A modified grounded theory approach (M‐GTA) was used. A total of 11 municipal PHNs participated in this study. Data were collected through semistructured interviews. Interviews were audiotaped and transcribed. A comparative analysis was performed using M‐GTA. Result: Five categories were identified. Japanese PHNs supported foreign residents while (1) maintaining a sincere attitude with curiosity and humility toward others regarding CC; (2) deepening their realization of issues arising from awareness of one's own and other cultures; (3) developing their knowledge about clients' cultures and the surrounding environments; and (4) mastering the skills of building a relationship with clients while creating supportive systems surrounding them. As they gained more experience in supporting foreign residents, as indicated in the above categories, their cultural competence grew, allowing them to (5) gain experience while encountering individuals without holding stereotypes and prejudice. Conclusions: The concepts of CC that emerged are based on cultural humility and are cultivated through supportive activities. The concepts identified in this study can serve as educational guidelines for health nurses and other care providers in Japan. [ABSTRACT FROM AUTHOR]

Objective: To examine the health‐housing relationship in low‐income older adults, and differences by income and receipt of housing assistance. Design: Secondary analysis of longitudinal survey data. Sample: About 10,858 adults aged 62+ who completed at least one wave of the 2014 Survey of Income and Program Participation (SIPP) (n = 37,333 observations). Measurements: SIPP variables representing demographics and housing quality, affordability, stability, and neighborhood were analyzed. Low‐income and higher‐income participants were differentiated by the household income‐to‐poverty ratio. Results: Low‐income participants were significantly more likely to be in poor health and report problems with housing quality, affordability, and neighborhood safety compared to higher‐income participants (p <.001). Increased household size and problems with housing quality and neighborhood safety were associated with poor health in both groups (p <.05). Low‐income participants who received housing assistance were significantly poorer, less healthy, and food insecure than participants not receiving assistance (p <.001); however, the health‐housing relationship was not different in the two groups. Conclusions: Results provide additional support for housing as a social determinant of older adult health. Though housing assistance programs reached a subset of low‐income older adults, the results suggest a housing assistance shortfall. Implications for public health nurses and researchers are explored. [ABSTRACT FROM AUTHOR]

Background: Public Health Nurses (PHN) caring for vulnerable populations amid systemic inequality must navigate complex situations, and consequently they may experience serious moral distress known to be detrimental to PHN wellbeing. Objective: Given PHN awareness of social inequities, the study aimed to determine if PHNs were motivated to enact social change and engage in social and political action to address inequality. Design and sample: A survey of 173 PHNs was conducted in fall 2022. The convenience sample was mainly female (96.5%), White (85%), had associate/bachelor's degrees (71.7%), and worked in governmental public health settings (70.7%). Measure: The study employed the Short Critical Consciousness Scales' subscales: Critical Reflection, Critical Motivation, and Critical Action. Results: PHNs were highly motivated to address inequities (Critical Motivation = 20.83; SD = 3.16), with similarly high awareness (Critical Reflection = 17.89; SD = 5.18). However, social and political action scores were much lower (Critical Action = 7.13; SD = 2.63). A subgroup of PHNs with strong agreement regarding the impact of poverty were more likely to be younger (p =.039) and work in a community setting (p =.003); with higher scores across subscales (p <.001). Conclusions: High critical reflection and motivation among PHNs aligned with literature. Lower Critical Action scores warrant investigation into validity for PHNs, and possible role constraints. [ABSTRACT FROM AUTHOR]

COVID‐19 pandemic brings to light similarities to the 1918 influenza pandemic, one of the deadliest outbreaks in United States history. The work of the Henry Street Visiting Nurse Service also referred to the public health nurses for that time, was a critical part of the New York City response. This case study examined Lillian Wald's leadership in directing the public health nursing response in New York City during the second wave of the influenza pandemic, from September through December of 1918. A historical social framework was used. Primary sources included the Lillian Wald Papers in the Rare Book and Manuscript Library, Columbia University in New York, Wald's (1934) Windows on Henry Street, medical, public health and nursing documents, journals, and newspaper articles published during the early 20th century. Secondary source material include works by historians Sarah Abrams, Arlene Keeling, Karen Buhler‐Wilkerson, Sandra Lewenson, John Barry, and Alfred Crosby. Key findings included developing a community wide strategic plan, using data driven decisions, implementing visiting nursing services, teaching in the home, and maintaining a diverse workforce. Lessons learned can guide leadership in emergency planning, system change, infection control and disease prevention, all familiar practices of public health nursing. [ABSTRACT FROM AUTHOR]

The article reports on the pressing need to establish a unified set of competencies for Public Health Nurses (PHNs) in order to bolster their workforce effectively. It mentions the complexity of PHN practice in diverse settings and the confusion caused by multiple competency sets, emphasizing the importance of competencies aligning with PHNs' roles.

Objective: To characterize patterns in whole‐person health of public health nurses (PHNs). Design and Sample: Survey of a convenience sample of PHNs (n = 132) in 2022. PHNs self‐identified as female (96.2%), white (86.4%), between the ages 25–44 (54.5%) and 45–64 (40.2%), had bachelor's degrees (65.9%) and incomes of $50‐75,000 (30.3%) and $75‐100,000/year (29.5%). Measurements: Simplified Omaha System Terms (SOST) within the MyStrengths+MyHealth assessment of whole‐person health (strengths, challenges, and needs) across Environmental, Psychosocial, Physiological, and Health‐related Behaviors domains. Results: PHNs had more strengths than challenges; and more challenges than needs. Four patterns were discovered: (1) inverse relationship between strengths and challenges/needs; (2) Many strengths; (3) High needs in Income; (4) Fewest strengths in Sleeping, Emotions, Nutrition, and Exercise. PHNs with Income as a strength (n = 79) had more strengths (t = 5.570, p <.001); fewer challenges (t = ‐5.270, p <.001) and needs (t = ‐3.659, p <.001) compared to others (n = 53). Conclusions: PHNs had many strengths compared to previous research with other samples, despite concerning patterns of challenges and needs. Most PHN whole‐person health patterns aligned with previous literature. Further research is needed to validate and extend these findings toward improving PHN health. [ABSTRACT FROM AUTHOR]

The Nurse‐Family Partnership is a targeted parenting intervention designed to improve maternal and child health. In Canada it is delivered exclusively by public health nurses who provide complex care to adolescent girls and young women. A process evaluation was conducted to better understand the experiences of public health nurses delivering the Nurse‐Family Partnership program in Canada. Although the traditional qualitative data analysis led to the creation of significant findings and clinical implications, it lacked the "heart" of public health nursing practice. Through a reflective process, and to present an evocative account of the multifaceted nursing care provided by the study participants, direct quotes were used to create a poetic display of nurses' experiences. Through the power of found poetry, the complexities of clients' lives, as well as the challenges and joys of home‐visitation nursing, were illuminated. [ABSTRACT FROM AUTHOR]

As child abuse becomes increasingly serious, the activities of nursing professionals during pregnancy have become more important. This study aimed to describe public health nurses' (PHNs) activities for child abuse prevention, focusing on how they approach pregnant women at possible risk to enable early prevention. A qualitative design was applied. Fifteen PHNs in Japan participated and were interviewed about 23 cases using semistructured interviews focus on the series of PHN's activity. Transcripts were coded, and the codes were categorized into several categories, and content analysis was conducted. PHNs' activities included exploring at‐risk cases by various means, creating opportunities to begin individual support, examining the risk of abuse specifically to predict suspected abuse after childbirth, encouraging behavior to reduce the risk of abuse, waiting consciously for a while, expanding support systems for cases. If PHNs anticipated that the situation would not stabilize, they returned to creating an opportunity to begin individual support and repeated the process. PHNs' had six activities, which were repeated depending on the magnitude of the risk of abuse. It was suggested that these activities are aimed at long‐term child‐rearing support. PHNs belonging to municipal governments conducted these activities; further support can be provided by utilizing municipal governments. [ABSTRACT FROM AUTHOR]

Public health nurses (PHNs) use principles of epidemiology in their work with communities; however, teaching these concepts at the baccalaureate level can be challenging. To reinforce the epidemiologic concepts taught in the classroom, two nursing faculty in our baccalaureate nursing program developed a population health project that allows students to explore concepts of epidemiology within the context of a population health concern. This article describes how the project provides students with a realistic opportunity to research the health issue. As a part of the project, students collect and analyze data about the health concern at the county, state, and national level. The project also requires students to identify local agencies who provide services for people who are impacted by the health issue and describe their role and function within the community. Furthermore, students discuss the roles and responsibilities of nurses in managing the population health concern under investigation. In doing so, students recognize how epidemiology informs population level nursing care. If nursing students understand epidemiological concepts, they will be better prepared to educate the communities they serve after graduation when a population health crisis, such as the recent COVID‐19 pandemic, occurs. [ABSTRACT FROM AUTHOR]

Objective: We evaluated whether Amagasaki health counseling programs led by public health nurses (PHNs) are contribute to improving cardiovascular disease (CVD) risk factors and CVD mortality among adult residents. Design and sample: This cross‐sectional study used a before‐and‐after comparative design. We evaluated data from health checkups and mortality before and after Amagasaki health promotion programs. Measurements: Population levels of CVD risk factors body mass index (BMI), waist circumference, systolic and diastolic blood pressure, fasting blood glucose, hemoglobin A1c, low‐density lipoprotein (LDL) cholesterol, high‐density lipoprotein (HDL) cholesterol, Triglyceride, aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid, γ‐glut amyl trans peptidase (γ‐GTP), serum creatinine, estimated glomerular filtration rate (eGFR) were compared between 2008 and 2012 when the intervention with the Amagasaki health counseling program started from 2008. In addition, standardized mortality ratio (SMR) of acute myocardial infarction (AMI) were compared between 2003–2007 and 2008–2012. Results: Mean value of most CVD risk factors improved and the SMR for AMI declined, which could be attributable in part to the effort of intensive health education and counseling. [ABSTRACT FROM AUTHOR]

Objective: Exploring how public health nurses (PHNs) provide community‐based support to women who are refugees and mothering. Design: A constructivist grounded theory (CGT) design was used where intersectionality as an analytical tool was applied. Varying data collection approaches including focus groups were used. Sample: Twelve PHNs from four public health units in Western Canada participated in this study. Results: Participants in this study described an overall process of creating safe relational space to address a basic social problem of establishing trust while managing structural forces. This overarching process was expressed through burning with passion, connecting while looking beyond, protecting from re‐traumatization, and fostering independence. Findings reveal strategies PHNs used to enhance health equity. This study extends critical caring theory to include sociopolitical and economic influences on public health nursing practice. Consequences of these influences on the mothering refugee women population are also revealed. Implications include structural integration of trauma‐and‐violence‐informed principles to support public health nursing practice. Conclusions: This study adds to an emerging body of knowledge on PHNs work with complex populations. Innovative application of intersectionality is demonstrated as an effective approach to analyzing impacts of broad sociopolitical priorities on communities that are systemically marginalized. [ABSTRACT FROM AUTHOR]

Objective: Public health nurses foster self‐help groups that are intended to solve health problems and improve the health of older people. This study aims to clarify how public health nurses foster such self‐help groups. Design: This is a qualitative study that utilizes one‐to‐one semi‐structured interviews. Sample: The participants comprised 11 full‐time public health nurses who had experience in fostering self‐help groups and had at least 5 years of experience as public health nurses. Measurements: Interview transcripts were created, and a qualitative analysis was performed inductively. Results: In total, 33 themes, 14 theme clusters, and four categories were extracted. The categories were as follows: coordinating with relevant occupations and residents to collect community information and solve health problems, organizing classes from health promotion to member‐centered group activities, ensuring group development support and establishing a support system, and supporting leaders behind the scenes. Conclusions: Public health nurses begin by gathering information about a given community and sharing local health problems with public health authorities and residents. The nurses build trusting partnerships with members and assign appropriate roles to them to better address their problems. Additionally, the nurses provide indirect group support by encouraging leaders as needed. [ABSTRACT FROM AUTHOR]

Objective: Parenting support has shifted from a problem‐focused to a strengths‐based solution‐focused approach. This study surveyed public health nurses to explain their intention to provide solution‐focused parenting support in their practice. Design: The design of this study was cross‐sectional. Sample: The initial sample included 781 public health nurses who were employed with various youth healthcare organizations in the Netherlands. Measurements: Based on the Theory of Planned Behavior, a questionnaire was developed and administered to measure (a) behavioral, normative, and control beliefs, (b) attitudes, subjective norm, and perceived behavioral control, and (c) intention. The data were subjected to structural equation modeling. Results: A total of 449 (57.5%) public health nurses completed questionnaires. Associations as indicated by the Theory of Planned Behavior were confirmed with the exception of that between perceived behavioral control and intention. Statistically significant paths and correlations were added. The final model accounted for 53% of the variance in the intention to perform solution‐focused parenting support. Conclusions: In this study, public health nurses strongly intended to provide solution‐focused parenting support, thus indicating their acceptance of the approach. Their intention was predominantly associated with subjective norm. [ABSTRACT FROM AUTHOR]

States across the country have been experiencing a steady decline in public health nursing workforce, including North Carolina (NC). Objectives: To better understand retention in the NC Public Health Nurses (PHNs) workforce through an assessment of perceptions of the working environment, stress, intent to stay, and job satisfaction. Design: A cross‐sectional online survey using closed and open‐ended questions. Sample: The study population comprised of non‐supervisory PHNs (n = 672) working at NC local health departments (LHD). Measurements: Retention problem, working environment, and job satisfaction measures were adapted from the revised Casey‐Fink Registered Nurse Retention Survey© (2009) to fit public health settings. Results: Despite high levels of job satisfaction (79.76%, n = 473), 53% of respondents (n = 323) acknowledged a retention problem within their LHD; 35.32% (n = 203) planned to/considered leaving their position in the next 3 years for reasons other than retirement. ANOVAs and Kruskal Wallis Test results showed that those planning to leave had statistically lower scores on perceived working environment and job satisfaction and demonstrated higher negative stress levels. Conclusion: Like other states, NC is experiencing a PHN shortages predicted to worsen in coming years. To retain the current workforce, LHDs need to work to improve PHNs working environment, increase PHNs' pay, and alleviate stressors. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the knowledge, skills, and attitudes (KSA) of public health nurses (PHNs) related to the eight Domains of the 2011 Quad Council Competencies for Public Health Nurses (QCC‐PHN). This manuscript is Part 2 of an exploratory study published in the Public Health Nursing journal on PHNs' knowledge, skills, attitudes, and application of the Quad Council Competencies (Harmon et al., 2020). Design: In this mixed‐method descriptive research study, the multisite team conducted an online survey among a convenience sample of 296 PHNs to determine differences in KSA for each of the eight QCC‐PHN Domains. Measurements: Analysis of variance (ANOVA) testing revealed differences in KSA for the QCC‐PHN, Domains. Post‐hoc tests and qualitative thematic analysis of PHNs open‐ended comments were used to provide additional data. Results: ANOVA results showed significant differences in knowledge and skills in all Domains and a significant difference in attitude in only one domain, Domain 7. Post‐hoc test results showed significant differences in KSA between position titles for most Domains. Conclusions: Recommendations include using the QCC‐PHN to standardize the professional and diverse roles of the PHN workforce. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify factors related to the practical utilization of community health needs assessment (CHNA) models that public health nurses (PHNs) learned in their fundamental education. Design: A nationwide questionnaire survey was conducted via postal mail. Sample: We randomly selected 630 public health institutes in Japan. The participants were 3397 full‐time novice and mid‐level PHNs. Measurements: The questionnaire included the participants' basic personal information, six items regarding the perception of CHNA with a 4‐point Likert scale, learned models in their undergraduate education, their utilization in practical settings, and the reasons for their answer in narrative form. Results: There were 951 valid responses. The results of logistic regression showed that the significant positively factors with model utilization were perception of CHNA as "not troublesome" or "not impossible as they learned," continuing education with 5 years of experience, and identification of the learned model in continuing education. Furthermore, the results of text mining showed the reasons for non‐utilization of the model included being "busy" and having a lack of "opportunity." Conclusions: This study showed the associated factors with rare utilization of a learned model for PHNs. These findings may suggest improvement of continuing education and development of an appropriate assessment model. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to elucidate the experiences of public health nurses (PHNs) in Japan during the first wave of COVID‐19. Design and sample: Twelve PHNs in charge of responding to COVID‐19 in X‐city within Tokyo metropolis in Japan participated in this case study. Measurements: Data were collected through self‐administered questionnaires and semi‐structured interviews on PHNs' experiences from January 2020 to May 2020. Results: Initially, only infectious disease control division (IDCD) PHNs experienced confusion due to the rapidly increased workload. Managerial PHNs attempted to explain the need for a dispatch system for the IDCD, using available statistical data from other managerial members, within one's maximum understanding of this unprecedented situation. Without having a clear and forward‐looking understanding regarding the purpose and reasons for dispatching, some dispatched PHNs had concerns and frustrations; they did not view the COVID‐19 pandemic as a disaster. In the never‐ending, exhausting work, PHNs managed to modify the provision of conventional services to residents. Conclusions: Despite experiencing confusion, PHNs worked to continuously provide community services, re‐considering the meaning of public health nursing. Prioritizing the work and shifting tasks to other professionals at an early stage of the pandemic may prevent organizational dysfunction. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to clarify the status of novice public health nurses' home‐visit skills during their first year of practice. Design and sample: A one‐year longitudinal observational study was conducted with 80 novice public health nurses. The participants were recruited from the four Japanese prefectures and their affiliated municipalities selected by using stratified sampling. Measurements: Self‐administered questionnaires were distributed three times between April 2016 and March 2017, asking about home‐visit experiences, understandings of the significance of home‐visit, and the levels of home‐visit skills. Data were analyzed with paired t‐tests and Wilcoxon signed‐rank tests. Results: All of twenty skills' self‐ratings significantly increased between the fourth and eighth months; five skills continually increased between the eighth and twelfth months. Both of Physical Assessment and Relationship Development Skills improved to the "Can do, almost by myself" level at the twelfth month; other skills remained at the "Can do, with a little advice" level. Conclusion: Although novice public health nurses improved to conducted home‐visits independently, they didn't perceive themselves as being able to do so in their first year. Therefore, through preparing guideline, organizations should provide intentional support to assist their skill acquisition during their first, and even in their second year. [ABSTRACT FROM AUTHOR]

Objectives: Undocumented migrant children (UMC) are often affected by policies and practices that do not take their best interests into account. The aim of this study was to describe how public health nurses (PHNs) experienced challenges and dilemmas in ensuring the best interests of the undocumented migrant child. Design: This study had a qualitative descriptive design. Sample: Focus group interviews and semi‐structured interviews were conducted with seven PHNs in four different child health centers (CHCs). Results: Qualitative content analysis was applied. Three main themes were identified: building trust, ensuring the best interests of the child, and dilemmas and challenges in ensuring the best interests of the child. The study revealed examples of immigration policy being prioritized over the best interests of the child. PHNs experienced frustration when the best interests of the child were not taken into account. Strategies for managing these conflicting demands were identified. Conclusion: Conflicting demands appeared when national immigration policies collided with fundamental human rights and ethical standards. Rules that exclude certain groups are incompatible with PHNs professional ethics. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify the characteristics of mothers who are at a high risk for future child maltreatment and therefore, require continuous support from public health nurses (PHNs) to prevent child maltreatment and those who do not require it. Design and samples: This retrospective cross‐sectional study included women who were registered in 2018 for being at risk for future child maltreatment and required help with childrearing in City A within the Tokyo metropolis. Measurements: Public health nurses registered data pertaining to each mother, including demographic data, family‐related variables, assessment by PHNs, use of maternal and child healthcare services, and continuity of support from PHNs. Results: Of the 206 cases, the discontinued group—comprising those who no longer needed PHNs' support—included 83 cases (40.3%) and the continuing group—comprising those needed continuing support—included 123 cases (59.7%). Logistic regression analysis showed that those with marital conflicts, maternal mental instability, lack of parenting skills, and not moving out of the city were more likely to require continuous PHNs' support. Conclusions: By identifying these factors, PHNs can identify new mothers who need continuous support and provide more concentrated care for them. Thus, support from PHNs can help prevent child maltreatment. [ABSTRACT FROM AUTHOR]

Objectives: Exploring views and experiences of public health nurses of their work environment and measurement of care practices at first postnatal visits. Design: An exploratory qualitative design. Data collected using four focus groups and analyzed using thematic analysis. Sample: Nineteen public health nurses from four health service regions in Ireland participated. Results: Two themes emerged. Theme one identified "challenges of providing a quality service." Public health nurses identified workload demands and that the working environment can detract from the ability to provide a quality service. Challenges within the home, language barriers, and lack of support from management were key issues. Theme two identified "challenges of measuring quality of public health nursing practice." While Measuring practice through quantitative outcomes such as key performance indicators were viewed as inadequate to measure the quality of care provided, positive views of using quality process indicators to measure the quality of their practice emerged. Conclusions: Key issues concern the working environment of public health nurses and challenges of providing and measuring care practices. Absence of appropriate supports and resources means public health nurses work hard to provide quality care. Public health nurses were confident they would score high on quality process measurements of their practice. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore the practical use of Health and Education Passport (HEP) for children in foster care and the role of the Foster Care Public Health Nurse (FCPHN) in tracking health and education records. Background: Children in foster care have complex health problems and experience frequent changes in home and school placements that result in gaps documentation. California mandates an HEP for every child in foster care. Design: Utilizing an online survey, PHNs describe their agency's use of the HEP, reported how they obtain health and education records for the HEP. Results: Social workers, PHNs and mental health providers were main HEP users, less so for foster parents and youth who age out of foster care. The HEP was used at medical and dental visits. PHNs reported little to no participation in updating educators. The HEP may be most useful when the child moves to a new placement or school. Conclusion: The HEP is a critical document that ties a fragmented health history together. Relevance to Clinical Practice: This study describes the foster care PHN role in updating the HEP and accessing health services and establishing a medical home. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this study was to describe the role of public health nurses working with lesbian, gay, bisexual, and transgender (LGBT) children in foster care in the San Francisco Bay Area. Background: LGBT youth are disproportionately represented in foster care and experience poor health and education outcomes. Foster care public health nurses (FCPHN) are in a unique position to address disparities with timely and appropriate referrals and advocate for policy changes. Design: An online survey was developed to describe FCPHN responsibilities in case managing LGBT children. Method: In all, 39 FCPHNs completed the survey. Results: Most FCPHN did not know the number of LGBT youth in their caseload and reported that there was no systematic method of collecting this data. Few FCPHN had received training in LGBT health issues. Conclusion: This study confirms reports from other studies regarding lack of systematic data collection to deliver appropriate services to LGBT youth. It reports FCPHN lack of training as well as their assessment of the most important needs of this population. Relevance to clinical practice: FCPHNs are in a unique position to advocate by promoting gender inclusive forms in child welfare agencies and addressing disparities in access to care. [ABSTRACT FROM AUTHOR]

Background: Attachment theory shows that childhood experiences influence the parenting style that the child shows later, as a parent. Nevertheless, at present there are no instruments to efficiently quantify the emotions associated with parents' early attachment. Objective: This study aims to develop a cognitive scale that measures both the positive and negative emotions reflecting the early attachment experience of Japanese mothers now nurturing their own preschool‐age children. Design: A Parental Attachment Recognition Scale is developed in three phases that include concept analysis, item pool development and validity analysis, and investigation of the scale's statistical features, factor structure, validity, and reliability. Measurements and Sample: The scale development is based on a self‐administered questionnaire survey, answered by 639 mothers. Results: The scale consists of 27 items, grouped by factor analysis into three subordinate scales, named: (1) Parent–child contact; (2) Emotional bond; and (3) Parental impressions. Conclusions: The study proposes a new scale to measure the recognition of early childhood attachment experiences among mothers raising their own preschool children. The instrument has a considerable degree of validity and reliability. The scale is expected to be useful in helping public health nurses assess mothers in need of childrearing support. [ABSTRACT FROM AUTHOR]

Dr Loretta C. Ford is a true pioneer. Her work in public health launched the nurse practitioner movement. Together with Dr Henry Silver in 1965, Dr Ford co‐founded the first expanded or advanced role to educate nurses to: assess, diagnose and treat common pediatric problems in primary care. Since then, there has been an increase in the number of specialty programs and an acknowledged global need for advanced practice nurses. She transformed our understanding of health and illness, the education of nurses, and the practice of humane patient care. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this study was to describe the role of Public Health Nurses (PHN) addressing the needs of children and adolescents in foster care. Background: Children in foster care have more physical, mental, dental, developmental health problems than the general pediatric population. National data indicate that between 30%‐80% of children come into foster care with at least one physical health problem. Design: An online survey was developed to describe PHN day‐to day activities, PHN funding, case load and case management responsibilities. Method: Thirty‐nine PHNs completed the survey (72% response rate). Results: Nurses described the most important needs as being mental and emotional health services, self‐esteem/self‐worth and dental care. Care coordination, case management and monitoring/oversight of psychotropic medications were the top responsibilities. Conclusion: The study demonstrated that public health nursing expertise is an essential part of the child welfare team in addressing medical, dental, mental and developmental needs of children in foster care. Relevance to Clinical Practice: There is an expanding role of Public Health Nurses in non‐health care settings to intervene at the system level of the Intervention Wheel that includes policy development and enforcement, community organizing, and coalition building. [ABSTRACT FROM AUTHOR]

Objective: To test the relationship between job satisfaction, professional self‐image, work environment, organizational commitment (OC), and quality of life at work (QoLW) among public health nurses in Israel. To determine which variables can predict OC and QoLW among public health nurses. Design and Sample: One hundred and thirty‐two public health nurses participated in this cross‐sectional study with a structured self‐administered questionnaire that examined OC, professional self‐image, job satisfaction, nursing work environment, and QoLW. Pearson correlation tested correlations between variables and multiple regression was conducted to predict OC and QoLW. Measurements: The five measurements (job satisfaction, professional self‐image, work environment, OC, and QoLW) based on validity questionnaires with high internal confident. Results: All five variables showed a significant positive correlation. Job satisfaction (t = 5.77, p < 0.001) and nursing work environment (t = 4.55, p < 0.001), contributed significantly to the explanation of OC and QoLW variance. Nursing work environment (t = 6.42, p < 0.01) and job satisfaction (t = 2.99, p < 0.01) were the variables that predicted QoLW. Conclusions: Nursing managers should be proactive and create a professional environment for nurses to encourage their OC and QoLW as factors that may influence public health nurses. [ABSTRACT FROM AUTHOR]

Objective: To assess staff attitudes, knowledge, and current practices in billing third‐party payers for sexually transmitted disease (STD) services in public health departments/districts. Design and Sample: A cross‐sectional, online survey was administered to staff at 60 urban and rural health departments/districts. Snowball sampling was used for greater representation. There were 311 staff responses from 56 agencies represented in the data analysis. Of the 311 responses, 106 were public health nurses and seven of the health directors had nursing backgrounds. Measurement: The survey measured attitudes, knowledge, and current billing practices for STD services. Analysis of data was performed at both individual and agency level. Results: Almost 90% reported it was acceptable to bill insurance. However, 56% felt these services should remain a "free" service in the agency. Most agencies were billing Medicaid for STD services (95%) and 70% bill private third‐party payers. Conclusions: Current funding for public STD clinics is not sustainable and other viable income streams such as third‐party payer reimbursement must be utilized. Public health nurses play a pivotal role in developing policies and procedures in billing third‐party payers for STD and other clinical services. Understanding the interactions between attitudes, knowledge and practice are vital in this development. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate public health nurses' experiences of using interpreters when meeting with Arabic‐speaking first‐time mothers. Design and Sample: An inductive qualitative design was used. Individual interviews were conducted with Swedish public health nurses (n = 11) with experience of working in child health care with interpreters when meeting with Arabic‐speaking first‐time mothers. Measures: Data were analyzed using qualitative content analysis. Results: The analysis of the interviews resulted in one overarching theme: Having to accept and learn to incorporate interpreters when meeting with Arabic‐speaking first‐time mothers. Three subthemes were identified: (a) enabling an understanding of the situation of the mothers; (b) contributing to a trustful relationship; and (c) creating disturbing elements in the dialogue. Conclusions: Using interpreters optimized the conversation between the public health nurse and the Arab‐speaking first‐time mother; however, the complexity of using interpreters was also apparent. [ABSTRACT FROM AUTHOR]

Abstract: Objective(s): The purpose of this manuscript was to describe: Public Health Nurse (PHN) home‐visited, female client Nutrition Knowledge (K), Behavior (B), and Status (S); the number and types of nutrition interventions PHNs used with these clients; and the types of clients receiving nutrition interventions. Design and Sample: This descriptive study used PHN‐generated Omaha System, electronic health record data from January 2012 to July 2015. The analytic sample contains 558 women who received home visits in a rural Midwestern U.S. county that employed universal nutrition assessment for clients. Measurements: Omaha System data included nutrition KBS scores (from 1 = low to 5 = high) and nutrition interventions delivered. Analyses included descriptive, bivariate, and multivariate analyses (means, frequencies, chi‐squares, general linear models). Results: PHNs assessed nutrition KBS scores for 84.1% of clients; average Nutrition Knowledge was 3.4 (SD = 0.7), Behavior 3.7 (SD = 0.8), and Status 4.3 (SD = 1.0). PHNs provided 0‐36 nutrition interventions per client. Nutrition intervention patterns were detected by the type of visit clients received. Conclusions: Results suggest home‐visited women have room to improve Nutrition KBS and PHNs utilize myriad nutrition interventions. Results also point to opportunities to improve home‐visited client care by providing more nutrition interventions, especially to those not receiving interventions, and revising standard care plans to reflect important Case Management nutrition interventions. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. Materials and Methods: A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two‐step evaluation was conducted which included a questionnaire and in‐depth phone interviews. Results: Twenty‐eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in‐depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. Discussion: The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. Conclusion: We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. [ABSTRACT FROM AUTHOR]

Public health nurses (PHNs) working in Well Baby Clinic in Israel's Haifa district were voicing great distress to inspectors—the impossibility of meeting their workload, feeling overwhelmed, poor physical, and technological conditions. They were feeling tired and frustrated and burn‐out was rising. The district's nursing management took the decision, together with Tel Aviv University's nursing research unit, to conduct a quality improvement project based on issues that arose from meetings with focus groups on the nurses’ difficulties. This paper is a case study of a quality improvement project targeting nurses daily working life. One of its chief contributions is as a study of meeting PHNs’ frustration by integrating focus groups and round‐table brainstorming (involving nurses, clinic managers and nursing inspectors) in order to identify targets for practical intervention. This strategy has been very successful. It has provided the district's nursing management a battery of forcefully argued and realistically grounded proposals for making the work of Well Baby clinics more relevant to their communities and giving nurses (a) the conditions to meet their assignments and (b) greater professional self‐respect. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify the characteristics and health issues of residents in need of assistance in a town affected by the Great East Japan Earthquake, six weeks after the disaster, through an outreach initiative. Design and Sample: A cross‐sectional qualitative design was used. Public health nurses conducted comprehensive semi‐structured interviews during home visits with residents. A total of 5,082 residents from the affected town. Measures: These included demographic information, public records of the extent of the damages, and qualitative interview data to determine the urgency of the necessary interventions. Results: A total of 281 residents needed some kind of assistance and were identified as “requiring early intervention (within two weeks)” or “requiring assistance (within 12 weeks).” The most common health issue requiring early intervention was “interruption of treatment” (25.0%), followed by “need for mental care.” The most frequent health issue requiring assistance within 12 weeks was the “need for mental health care” (39.7%), followed by “interruption of treatment,” and “need for nursing care.” Conclusions: During a disaster, it is imperative to identify cases requiring early intervention. Home‐visit interviews were necessary to identify existing health concerns to prevent the development of more serious health problems. [ABSTRACT FROM AUTHOR]

To develop an action plan based on asthma management challenges identified by Head Start teachers in a multisite program. Design and Sample: Qualitative, participatory action research project. Three focus groups were conducted with Head Start teachers ( n=14), and 1 with Center managers ( n=15) in an urban Midwestern program. Measures: Brief background questionnaire and semistructured focus group interview guide. Content analytic techniques were used to identify and categorize asthma management issues in transcripts of teacher focus groups. Center managers verified the findings and recommended action plan strategies to address asthma management challenges. Results: Head Start staff identified 4 common challenges: (a) undiagnosed and unreported asthma, (b) coordinating asthma care with parents, (c) medication administration issues, and (d) variability among asthma action plans. The action plan focused on (a) early identification of asthma, (b) improving coordination of asthma care with parents, (c) developing more asthma education and resources for Head Start staff and parents, and (d) developing a standardized, comprehensive Head Start asthma action plan. Conclusions: Public health nurses can play a major role in ensuring quality care in Head Start programs by periodically identifying staff needs and developing strategies to address asthma management challenges. [ABSTRACT FROM AUTHOR]

This study investigated changes in public health nurse practices and the incidence of abuse inquiry and disclosure. Design and Sample: A retrospective record review of cross-sectional data was collected before and after implementation of the Routine Universal Comprehensive Screening (RUCS) protocol within a maternal child home visiting program. Records of postpartum women receiving a universal home visit within 48 hr of discharge from the hospital were reviewed (pre-RUCS, n=459; post-RUCS, n=485). Also reviewed were the records of women receiving a family assessment for at risk home visiting (pre-RUCS, n=79; post-RUCS, n=66). Measures: The variables collected consisted of abuse inquiry, abuse disclosure, and the alone status. Results: Documentation of women's alone status significantly improved for both types of home visits: the 48-hr home visits ( p<.001) and the at risk home visits ( p<.01). Disclosures of abuse significantly increased in both types of home visits ( p<.01). Ensuring privacy by not asking abuse questions if women were not alone during a visit significantly improved ( p<.001). Conclusions: Implementing a protocol to screen for woman abuse into an existing maternal child home visiting program demonstrated improved practices related to the safety and privacy of women, and an increase in abuse disclosures. [ABSTRACT FROM AUTHOR]

This descriptive qualitative study explores the use of a procedure for postpartum depression (PPD) screening by public health nurses in a Norwegian municipality, and is based on in-depth interviews. The 11 nurses regarded the screening procedure as valuable and felt that the training they had received in its use made them more confident about supporting parents by discussing mental health problems. They found the Edinburgh Postnatal Depression Scale easy to score and easy for the mothers to complete, and they identified PPD more frequently than before. Further research should explore parents' views on such screening and should investigate methods used for management of PPD in primary health care. [ABSTRACT FROM AUTHOR]

Leading a successful coalition that benefits both the members and the community is a difficult task. Coalitions are complex and require a great deal of skill to initiate, lead, and evaluate. This article examines a successful coalition, developed to build community capacity to address fetal alcohol spectrum disorder (FASD). FASD is a complex, multidimensional health issue common in many communities. Coalitions can be effective in tackling these types of issues and fit with community capacity-building approaches to health promotion. The Internal Coalition Outcome Hierarchy (ICOH) model (Cramer, Atwood, & Stoner, 2006a, 2006b) is used to retrospectively examine the internal constructs of the FASD Action Network and provide useful lessons learned for other coalition leaders and public health nurses. This hierarchical model demonstrates that sound internal processes lead to more successful outcomes and ultimately an increased impact on community issues. The usefulness of ICOH as a tool in evaluating the FASD Action Network and its application to other health-promotion situations with community capacity goals is described in this article. [ABSTRACT FROM AUTHOR]

To describe the environmental health (EH) demands placed on public health nurses (PHNs) as well as the barriers and facilitators to incorporating EH into PHN practice. Design and Sample: A cross-sectional multimode (Web and pencil/paper) survey was used to collect data from PHNs in 1 rural western state. Research participants included 141 PHNs from a total of 228 survey invitations (61% response). Measures: A 39-item questionnaire was developed to measure the frequency of EH demands experienced by PHNs as well as the barriers and facilitators to the incorporation of EH into PHN practice and standard demographics. Results: Significant numbers of PHNs reported less than baccalaureate preparation (29%), suggesting that EH competencies cannot be assumed. PHNs are often asked for basic EH information and cite lack of time and lack of interest on the part of the populations being cared for as barriers to incorporating EH into their practice. Facilitators included free or inexpensive continuing education programs offered via the Internet and additional Internet resources or staff resource people. Conclusion: PHNs represent a significant portion of the public health workforce and have implied and explicit mandates to address EH issues in their practice. Resources should be directed toward helping PHNs become better prepared to address the current and future EH needs of populations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effect of a cultural intervention (CI) on increasing adherence to latent tuberculosis infection (LTBI) therapy among Latino immigrants. Design and Sample: This clinical study used a preexperimental design. A nonprobability sample of 86 Latino immigrant clients who were starting LTBI therapy were enrolled in the intervention. The comparison group was an historical sample of 131 clients' records randomly selected from the previous year. Intervention: The CI, designed by the principal investigator, was delivered by 2 Spanish-speaking interventionist nurses at each of 9 clinic visits. The intervention was based on Latino cultural values and included 5 components. Measures: The patients' adherence was measured by a self-report of the number of pills taken. Results: The findings of this study were that clients in the CI group took a significantly greater number of doses of INH than those in the historical sample. Conclusions: Using a CI to increase adherence to LTBI therapy shows promise for public health nursing practice. [ABSTRACT FROM AUTHOR]

This paper explores the current literature related to legal issues encountered by the public health nurse in Ireland in visiting clients exhibiting self-neglecting behavior. Nurses working in community settings where home visiting of clients is required will at some point encounter situations of client self-neglect. Possession of a clear legal framework for the local area that addresses both the nurse's professional responsibility and the client's rights is needed. Because a high incidence of depression and dementia seen in self-neglecting adults has prompted calls for wider screening of the agreeable client, an understanding of the definition of competence and capacity in the national legal system for that client becomes critical. In Ireland, as in many other countries, refusal of care or screening is the right of any competent adult. However, issues of mandatory reporting, confidentiality, and trespass may differ from other areas. Nursing care delivered at the community level to a client exhibiting self-neglecting behavior involves a delicate balance of trust and support. Through this overview of the legal implications for self-neglecting clients in Ireland, nurses have the opportunity to begin an exploration of similarities and differences in approach on a global level. [ABSTRACT FROM AUTHOR]

Public health nurses in local health departments may receive the first call regarding a potential case of avian influenza, monkeypox, or viral hemorrhagic fever. One public health approach to containing these dangerous infectious disease outbreaks is the use of specialized isolation units. Early access to a biocontainment patient care unit (BPCU) for isolation during a bioterrorism or public health emergency event along with appropriate use of epidemiological and therapeutic interventions in the community may dramatically impact the size and severity of a disease outbreak ( Smith et al., 2006 ). As emerging infectious agents, pandemics, resistant organisms, and terrorism continue to threaten human life; health care and emergency care providers must be empowered to work with nurses and other professionals in public health to plan for the consequences. This article describes the evolution of Nebraska's BPCU strategy for public health preparedness in the face of a biological threat. Design priorities, unit management, challenges, and lessons learned will be shared to guide others in establishing similar infrastructure. [ABSTRACT FROM AUTHOR]

The original article from which these excerpts were taken, “Some Hints to the Nurse Who Seeks to Become a Successful Partner in the Community Health Program,” by Mary Margaret Muckley, was published the 1923 volume of the original Public Health Nursing journal. The paper listed practical pointers to nurses wanting to work in the area of public or community health nursing. The author's advice involved personal attributes, professional engagement, skills, effective organization, and community relations. Much of the original article contained sound advice for aspirants to nursing work in community settings, but some advice may be considered too idealistic even for this optimistic time period. While the particular references to organizations and agencies existing in Helena, Montana have been omitted, the nurse reading the paper in 1923 had a general guide to her key stakeholders. The excerpts from this paper may give contemporary readers an appreciation of the endurance of what Muckley terms the public health nurse's “Valuable Assets.” [ABSTRACT FROM AUTHOR]

To report the population health surveillance functions of public health nurses and to describe factors that impede these functions. Design and Sample: An interpretive qualitative study was conducted in Public Health Service areas in Eastern Canada. Participants were public health nurses ( n=55) with an average of 14.5 years of pertinent work experience. Measures: Semistructured face-to-face, telephone interviews, and focus groups were conducted, transcribed, coded, and analyzed. Results: The nurses in this study used ecosocial population health surveillance functions that included multilevel societal influences on health. Extensive interprofessional and intersectoral networks were foundational to their surveillance work, allowing them to monitor what was occurring in the community and transfer this knowledge into various systems to contribute toward improved health outcomes. However, the nurses did not acknowledge the significance of their population health surveillance work, and documentation structures did not support these surveillance functions. Conclusion: New surveillance methods and documentation structures that reflect an ecosocial surveillance approach are needed that are more consistent with public health nurses' population-focused practice. [ABSTRACT FROM AUTHOR]