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Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An evidence-based e-health program, e Care We Care, was developed to disseminate information on diabetes management through web-based interactive tutorials. This study examined the effect of the e Care We Care program on diabetes knowledge development in African American adults with low diabetes literacy. Forty-six African American adults with type 1 or type 2 diabetes and low diabetes literacy were recruited from two health-care centres in eastern Winston Salem, North Carolina. The e Care We Care program included four weekly sessions: introduction to diabetes; eye complications; foot care; and meal planning. Significant differences in scores on the diabetes knowledge survey were demonstrated between the e Care We Care program participants and the comparison group. Study findings indicate the e Care We Care program is more effective in improving diabetes knowledge of African American adults with low diabetes literacy than paper-based, text-only tutorials. The e Care We Care program can be an effective educational strategy for improving diabetes knowledge and decreasing diabetes disparities among African American adults. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand Black women's perspectives on a pre‐exposure prophylaxis (PrEP) education intervention in a salon setting. Background: Black women have a significant lifetime risk of acquiring HIV. Pre‐exposure prophylaxis (PrEP) is an effective prevention approach in reducing that risk. Despite this, Black women are least likely to use PrEP. Design: This was a qualitative study to identify Black women's perspectives on acceptability of a PrEP education intervention in a salon setting using hair stylists. The paper adhered to the COREQ checklist in reporting. Methods: Seven focus groups among Black women (n = 44) living in north‐central North Carolina were conducted. Ethical approval was obtained. The interview guide included questions on knowledge of PrEP and barriers and facilitators to a PrEP promotion programme in a salon setting. Results: Conventional content analysis considered content in relation to themes of facilitators, barriers and women's preferences for intervention delivery. Facilitators included the salon characteristics, social culture and relationship with the stylist. Women noted concerns of accuracy of content from stylists and privacy as barriers. Conclusions: Participants' trust with their stylists make a PrEP education salon‐based intervention feasible. Salon‐based interventions are not one‐size‐fits‐all and researchers interested in this setting should tailor interventions to the individual salon. Interventions for PrEP in a salon setting should be culturally appropriate, confidential and consider the potential reach to the social networks of Black women in the salon. Relevance to clinical practice: The insights shared by Black women can contribute to developing a PrEP uptake intervention as a way of reducing new cases of HIV. [ABSTRACT FROM AUTHOR]

This paper describes a highly successful, 10 year long international videoconference exchange between nursing students in Iwate Prefectural University in northern Japan and the University of North Carolina Wilmington in the United States. A summary of the literature on the use of videoconferencing in nursing education is presented, as well as a brief overview of the collaborative partnership that led to the development of the annual videoconference series. A description of the process for conducting the annual real-time sessions is included along with student perspectives about their experiences. Planning, support and open-mindedness on the part of both students and nursing faculty have contributed to the success of this collaborative effort. [ABSTRACT FROM AUTHOR]

Aims/objectives: Through interviews with clinical service providers, we explored stigma's impact on HIV service provision for African Americans during COVID‐19. Background: African Americans experience disproportionate rates of HIV and COVID‐19. We explored COVID‐19's impact on HIV services for African American adults in a Southern city. Design: The study was qualitative and observational. Methods: Key informant interviews were conducted (n = 11) across two healthcare centres and two community‐based organisations and thematically analysed using phenomenological approaches by two coders. Interviews explored pre‐ and post‐COVID‐19 service provision and parallels between COVID‐19 and HIV, particularly as related to stigma. The COREQ checklist was utilised to ensure research quality. Results: According to the providers interviewed, all providers offered HIV prevention/treatment, but PrEP and preventive services diminished greatly early in the COVID‐19 pandemic. Successful transition to telehealth depended on existing telehealth use. Challenges exacerbated by COVID‐19 included food/housing insecurity and physical distancing constraints. Clients' COVID‐19 informational needs shifted from concerns to vaccine requests over time. Interviewees stated HIV and COVID‐19 both carry 'risk taking'; however, HIV risk was more physically intimate than COVID‐19. Notably, some providers used stigmatising language referring to clients with HIV/COVID and omitted person‐centred language. Conclusions: Findings suggest need to address challenges in telehealth to improve client experiences now and for future pandemics. More research is needed to examine intersectional stigmatisation of COVID‐19 and HIV for African Americans to design person‐centred counselling interventions. Relevance to Clinical Practice: Results demonstrate need for provider training to reframe stigma discussions using client centeredness, educating African Americans on HIV and COVID‐19 prevention, and coordination with local organisations to address multiple care needs. Patient/Public Contribution: This research highlights needs of clients based on the views of healthcare providers caring for predominantly African American communities in a Southern city. However, no patients, service users, caregivers or members of the public were directly involved in this study. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an evaluation of the psychometric properties of the Health Beliefs Related to Cardiovascular Disease Scale designed to measure beliefs related to cardiovascular disease risk and diet and exercise in adults with diabetes. Background. Heart attack and stroke are 2-4 times more common among adults with diabetes than those without diabetes. To reduce this risk for patients with diabetes, understanding beliefs about cardiovascular disease risk and risk-reduction strategies is important. Methods. Item development for the 25-item self-report Likert scale was guided by literature review, expert panel review and focus-group feedback. It consists of four subscales, measuring four constructs of the Health Belief Model: perceived susceptibility and severity of cardiovascular disease and benefits and barriers to diet and exercise. A convenience sample of 178 adults with self-reported type 2 diabetes completed the survey between August 2006 and March 2007; 42 participants completed it again 2-3 weeks later to evaluate test-retest reliability. Results. The instrument has more than one dimension, with the best fit identified using a two-factor model specifying the Benefits and Susceptibility subscale items, rather than the four-factor solution as predicted. The Susceptibility and Benefits subscales demonstrated stable factor structure and acceptable reliability (a = 0.93 and a = 0.82 respectively). The Barriers and Severity items demonstrated unstable factor structure and poor internal consistency (a = 0.70 and a = 0.61 respectively). Conclusion. Only the Susceptibility and Benefits subscale items can be used in their current form. The Barriers and Severity items need further refinement including revised wording with clearer focus and evaluation with a larger, more diverse sample. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore nursing home residents' perspectives on their relationships with other residents, family members and staff. Background: The cultivation of social relationships is central to promoting well‐being in nursing homes, as these relationships allow residents, family members and staff to be valued as unique persons and empowered as partners in care. Few studies have examined how nursing home residents perceive the relationships in their social networks, both within and beyond the facility. Design: Qualitative secondary analysis. Methods: We analysed individual and group interviews obtained during "stakeholder engagement sessions" with cognitively intact residents (N = 11 sessions; N = 13 participants) from two nursing homes in North Carolina. The interviews were conducted as part of a larger study on person‐directed care planning. We integrated thematic and narrative analytic approaches to guide the analysis of interview data, using a three‐cycle coding approach. The COREQ checklist was followed. Results: Four broad themes emerged from this analysis: (a) peer relationships foster a sense of belonging, purpose, achievement and significance; (b) residents' relationships with family members support a sense of belonging, continuity and significance; (c) mutual respect and reciprocity between residents and nursing home staff promote a sense of belonging and significance; and (d) organisational factors pose barriers to forging meaningful relationships. Each type of relationship—peer, family and staff—made distinctive contributions residents' psychosocial well‐being. Conclusion: Recognising the diverse roles of different actors from residents' social networks raises questions for future research to optimise the distinctive contributions of network members that promote residents' psychosocial well‐being. Relevance to clinical practice: This study highlights the need for nursing home staff to understand how residents' social relationships influence residents' psychosocial outcomes. Staff training programmes are needed to support residents' rights and to dispel inaccurate interpretations of regulations that threaten sustained meaningful relationships. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine whether a single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure. Background Poor medication adherence is associated with increased morbidity and mortality. Having a simple means of identifying suboptimal medication adherence could help identify at-risk patients for interventions. Design We performed a prospective cohort study in 592 participants with heart failure within a four-site randomised trial. Methods Self-report medication adherence was assessed at baseline using a single-item question: 'Over the past seven days, how many times did you miss a dose of any of your heart medication?' Participants who reported no missing doses were defined as fully adherent, and those missing more than one dose were considered less than fully adherent. The primary outcome was combined all-cause hospitalisation or death over one year and the secondary endpoint was heart failure hospitalisation. Outcomes were assessed with blinded chart reviews, and heart failure outcomes were determined by a blinded adjudication committee. We used negative binomial regression to examine the relationship between medication adherence and outcomes. Results Fifty-two percent of participants were 52% male, mean age was 61 years, and 31% were of New York Heart Association class III/ IV at enrolment; 72% of participants reported full adherence to their heart medicine at baseline. Participants with full medication adherence had a lower rate of all-cause hospitalisation and death (0·71 events/year) compared with those with any nonadherence (0·86 events/year): adjusted-for-site incidence rate ratio was 0·83, fully adjusted incidence rate ratio 0·68. Incidence rate ratios were similar for heart failure hospitalisations. Conclusion A single medication adherence question at baseline predicts hospitalisation and death over one year in heart failure patients. Relevance to clinical practice Medication adherence is associated with all-cause and heart failure-related hospitalisation and death in heart failure. It is important for clinicians to assess patients' medication adherence on a regular basis at their clinical follow-ups. [ABSTRACT FROM AUTHOR]

Aim and objectives. We sought to identify the feasibility and predictive validity of an easy and quick self-reported measure of medication adherence and to identify characteristics of people with hypertension that may warrant increase attentiveness by nurses to address hypertensive self-management needs. Background. Current control rates of hypertension are approximately 50%. Effective blood pressure control can be achieved in most people with hypertension through antihypertensive medication. However, hypertension control can only be achieved if the patient is adherent with their medication regimen. Patients who are non-adherent may be in need of additional intervention. Design. This secondary analysis evaluated the systolic blood pressure of patients who received usual hypertension management across 24 months at six-month intervals. Methods. A longitudinal study of 159 hypertensive patients in two primary care clinics. Results. In a sample of 159 patients receiving care in a primary care facility, baseline medication non-adherence was associated with a 6·3 mmHg increase in systolic blood pressure ( p < 0·05) at baseline, a 8·4 mmHg increase in systolic blood pressure ( p < 0·05) at 12 months and a 7·5 increase in systolic blood pressure at 24 months ( p < 0·05) compared with adherent patients, respectively. Results also indicate a significant increase in systolic blood pressure across 24 months among people who identified as minority and of low financial status. Conclusions. Non-adherence with antihypertensive medication at baseline was predictive of increased systolic blood pressure up to 24 months postbaseline. Relevance to clinical practice. This study demonstrates the use of an easy-to-use questionnaire to identify patients who are non-adherent. We recommend assessing medication adherence to identify patients who are non-adherent with their anti-hypertensive medication and to be especially vigilant with patients who are minority or are considered low income. [ABSTRACT FROM AUTHOR]

Aims and objectives. This study focused on differences in nurses' satisfaction with the quality of care of older people and with organisational characteristics and work environment in acute care and long-term care settings. Background. Numerous studies have explored links between nurses' satisfaction with care and work environments on the one hand and a variety of physical, behavioural and psychological reactions of nurses on the other. One key to keeping nurses in the workplace is a better understanding of nurses' satisfaction with the quality of care they provide. Design. Descriptive design. Method. The self-selected sample included 298 registered nurses and licensed practical nurses who provide care to minority, underserved and disadvantaged older populations in 89 long-term care and <100 bed hospitals in 38 rural counties and eight metropolitan areas in a Southern state. All completed the Agency Geriatric Nursing Care survey, which consisted of a 13-item scale measuring nurses' satisfaction with the quality of geriatric care in their practice settings and an 11-item scale examining obstacles to providing quality geriatric care. Demographic variables were compared with chi-square. Independent t-tests were used to examine differences between nurses in long-term care and acute care settings. Results. Significant differences were found in level of satisfaction and perceived obstacles to providing quality care to older adults between participants from acute and long-term care. Participants in long-term care had greater satisfaction with the quality of geriatric care than those in acute facilities. Conclusions. Nurses in long-term care were more satisfied that care was evidence-based; specialised to individual needs of older adults; promoted autonomy and independence of elders; and was continuous across settings. Participants in acute facilities perceived more obstacles to providing quality geriatric care than nurses in long-term care facilities. Relevance to clinical practice. Modification of hospital geriatric practice environments and leadership commitment to evidence-based practice guidelines that promote autonomy and independence of patients and staff could improve acute care nurses' perceptions of quality of geriatric care. [ABSTRACT FROM AUTHOR]

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