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Objective: This study explores perceptions about the role of telehealth in providing health and supportive services to Australian rural/regional cancer patients and survivor during COVID‐19 and the quality of these services to inform future practice. Design: Data were collected as part of a bi‐annual survey on client satisfaction at a rural/regional community cancer wellness centre in Australia. Settings and Participants: Rural/regional cancer patients and survivors (n = 66) completed an online survey. Main Outcome Measures: The three main outcome measures were: (1) attitudes towards telehealth; (2) preference for future cancer support services; and (3) experiences with video/telehealth. Results: Younger participants were more likely to use allied health services via video/telehealth during COVID‐19 than their older counterparts. The preferred format for cancer support services in future was face‐to‐face (59% for younger and 42% for older participants), telehealth (10% for both groups) and mixed (31% for younger and 48% for older participants). Conclusions: Telehealth has benefits for the delivery of health and supportive services to rural/regional cancer patients and survivors. Nurses can play a key role in assessing the support needs of cancer survivors and facilitating strategies to ensure that survivors have the skills necessary to access telehealth support. [ABSTRACT FROM AUTHOR]

Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts' nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an intervention targeting Certified Nurses' Aides (CNAs) was developed and tested. We hypothesized that following the training, CNAs would have increased knowledge and self-efficacy toward providing oral health care to the residents in their charge.

Background: Cancer-related financial hardship is linked to poor health outcomes and early mortality. Oncology financial advocacy (OFA) aims to prevent cancer-related financial hardship in oncology settings by assessing patients' needs and connecting them to available financial resources. Despite promising evidence, OFA remains underutilized. Objectives: Describe oncology financial advocates' perceptions about the challenges to and opportunities for implementing OFA in community cancer centers. Methods: Nine virtual focus groups were conducted with 45 oncology financial advocates. Focus group transcripts were analyzed using template-based thematic analysis informed by the Consolidated Framework for Implementation Research (CFIR); 2 study team members coded each transcript, and all 6 team members identified emergent themes. Results: Salient themes were identified across all 5 domains of the CFIR framework: (1) intervention characteristics: participants described challenges of adapting OFA to meet the needs of the medical system instead of the needs of the patients; (2) outer setting: growing awareness of health and cancer disparities could bring more attention to and investment in OFA; (3) inner setting: programs are underresourced to assist all at-risk patients; staffing, technology integration, and network/communication workflows are needed; (4) characteristics of individuals: advocates believe strongly in the effectiveness and would like to see their credibility enhanced with professional certification; and (5) process: implementation strategies that target the engagement of leadership, key stakeholders, and patients to increase program reach are needed. Conclusions: OFA cannot reach all at-risk patients because of understaffing, poor communication between departments, and a lack of understanding OFA as an intervention among colleagues, key stakeholders, and patients. To reach full implementation, advocates need assistance in making the case for more resources, research on patient outcomes, professional certification, and the use of policy to incentivize financial advocacy as a standard of care in medicine. [ABSTRACT FROM AUTHOR]

Social workers have a critical role on medical teams for facilitating effective conversations about advance care planning (ACP) in palliative and end-of-life care. Engaging patients in such conversations may be influenced by clinicians' attitudes. During the COVID19 pandemic, the need to examine barriers to serious illness care across healthcare settings and areas of specialty practice became abundantly clear. This study examines: (1) social workers' attitudes about ACP and (2) factors that influence the completion of advance directives (ADs). Using a cross-sectional study design, we surveyed 142 social workers on their knowledge, attitudes, and behaviors related to ADs. Using exploratory factor analyses, we identified 2 provider practice attitudes factors, 3 perceived barriers factors, and 2 perceived importance of AD factors. We then used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each of the factors in association with the frequency social workers reported educating patients about ADs. While various positive and negative attitudes and barriers toward educating patients are important factors to consider, social workers' perceptions of the importance of engaging patients in ACP education was the most important factor that influenced their behaviors. The odds of always/often (vs. sometimes/rarely/never) educating patients about ADs in their practice were greater for those social workers who reported they see the importance of AD decision-making (OR = 3.21, 95%CI = 1.83-5.62) and confirming goals-of-care (OR = 1.76, 95%CI = 1.03-3.01). Social worker's ACP knowledge and skills for educating patients are important in initiating conversations prior to a health crisis, especially important for developing a comprehensive care plan. [ABSTRACT FROM AUTHOR]

Sexual assault victimization and eating disorder rates are high among college populations and have significant psychological, physiological, and social outcomes. Previous research has found a positive relationship between experiences of sexual assault and eating disorder symptoms; however, these analyses have primarily focused on female students. Using data from the 2017-2018 Healthy Minds Study, the aim of this study was to investigate the relationship between experiencing a sexual assault within the previous 12 months and screening positive for an eating disorder among cisgender college-enrolled men. It was hypothesized that college-enrolled men who report experiencing a sexual assault within the previous 12 months would be more likely to screen positive for an eating disorder. Analyses were conducted using a sample of 14,964 cisgender college-enrolled men. Among the sample, nearly 4% reported a sexual assault within the previous 12 months and nearly 16% screened positive for an eating disorder. Results from logistic regression analyses indicated that college-enrolled men who reported experiencing a sexual assault in the previous 12 months, compared to those who did not, had significantly greater odds of screening positive for an eating disorder (OR = 1.40, p <.01). Analyses also indicated that college-enrolled men who identified as gay, queer, questioning, or other sexual orientation and reported experiencing a sexual assault in the previous 12 months had greater odds of screening positive for an eating disorder (OR = 2.50, p <.001) compared to their heterosexual peers who did not experience a sexual assault in the previous 12 months. These results indicate that eating disorders may be a negative outcome among college-enrolled men who have experienced a sexual assault, particularly among sexual minority men. Thus, mental health professionals need to be adequately prepared to treat the underserved population of men who experience an eating disorder and who have experienced sexual assault. [ABSTRACT FROM AUTHOR]

Background: Advance care planning for end-of-life care emerged in the mid-1970's to address the need for tools, such as the advance directive (AD) legal document, to guide medical decision-making among seriously ill patients, their families, and healthcare providers. Objective: Study aims examine providers' perspectives on AD education that involve examining (1) a range of attitudes about educating patients, (2) whether prior knowledge was associated with practice behaviors in educating patients, and (3) specific factors among healthcare providers such as characteristics of work setting, knowledge, attitudes, and behaviors that may influence AD education and documentation. Design: To examine providers' views, we conducted a cross-sectional, online survey questionnaire of healthcare providers using social media outreach methods for recruitment. Methods: This study used a cross-sectional survey design to examine the proposed aims. Healthcare providers, recruited through a broad approach using snowball methods, were invited to participate in an online survey. Logistic regression analyses were used to examine providers' views toward AD education. Results: Of 520 participants, findings indicate that most healthcare providers said that they were knowledgeable about AD education. They also viewed providing education as beneficial to their practice. These findings suggest that having a positive attitude toward AD education and experiencing less organizational barriers indicate a higher likelihood that providers will educate patients regarding ADs. Conclusion: Various disciplines are represented in this study, which indicates that attitudes and knowledge influence AD discussions. The importance of AD discussions initiated by healthcare providers is critical to providing optimal patient-centered care. [ABSTRACT FROM AUTHOR]

Background: Reports indicate that 4% of the adolescent males in 2015 had taken steroids without a doctor's prescription. Anabolic-androgenic steroids (AAS) are illicit drugs that have commonly been used to help build muscle mass. AAS use is associated with negative biological, psychological, and social side effects including substance use, suicidal behavior, and violent behavior. Objectives: This exploratory study, guided by an integrated theoretical framework that included the General Aggression Model and the Biopsychosocial Model, examined the relationship between adolescent male AAS use and teen dating violence. Methods: This cross-sectional, secondary data analysis was conducted using the 2013 and 2015 Massachusetts Youth Health Survey (MYHS). Participants were high school-aged males with a total sample of 2,080. Primary data analysis was conducted using hierarchical logistic regression. Results: Findings suggested that adolescent males who used steroids at least once in their lifetime, compared to those who did not, had greater odds of engaging in teen dating violence. Further, males who identified as a sexual minority had greater odds of using anabolic-androgenic steroids, as were those who had at least one suicide attempt in the previous 12 months. Conclusions: Adolescent male AAS use is associated with multiple psychosocial factors that practitioners, school personnel, and parents must be aware of. [ABSTRACT FROM AUTHOR]

Considerable racial and ethnic differences exist in the way the burden of cancer is experienced in the United States for older Hispanic women. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the mental health factors associated with older Hispanic women’s participation in breast cancer screening services. Logistic regression models were used. Findings indicated that anxiety and positive affect were associated with a greater likelihood of participating in breast cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population. [ABSTRACT FROM AUTHOR]

Early detection through screening can reduce mortality rates of cervical cancer, and yet Hispanic women who have incidence rates higher than their non-Hispanic White counterparts are least likely to participate in cancer screening initiatives. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the psychosocial correlates associated with older Hispanic women’s participation in cervical cancer screening services. Logistic regression models were used. Findings indicated that greater life satisfaction and religiosity were associated with a greater likelihood of participating in cervical cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population. [ABSTRACT FROM PUBLISHER]

Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts’ nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an intervention targeting Certified Nurses’ Aides (CNAs) was developed and tested. We hypothesized that following the training, CNAs would have increased knowledge and self-efficacy toward providing oral health care to the residents in their charge. This pilot study used a one-group pretest-posttest design to test the effectiveness of a psycho-educational training intervention. Utilizing the constructs of knowledge and self-efficacy from the Theory of Planned Behavior and the Social Cognitive Theory, we framed the content of a training intervention and administered a 21-item instrument. The survey was distributed to the CNA staff of a single midsize nursing home immediately prior to and after the intervention. The 1-hour training intervention was empirically supported by formative data and delivered by dental faculty researchers. Findings indicate increases in two areas of oral health knowledge: toothbrush position and frequency of brushing. Self-efficacy, however, did not significantly change. Although the results marginally supported our hypothesis, this pilot study demonstrates the feasibility of delivering interventions to CNAs who have direct responsibility for promoting the oral health of long-term care facility residents. [ABSTRACT FROM AUTHOR]

Health professions education is tasked with preparing the behavioral health workforce to provide accessible, high-quality, interprofessional care to meet the needs of geographically-isolated populations. Interprofessional experiences, like simulation, are an effective pedagogical tool, yet traditionally occur in-person. It is essential to adapt simulation experiences for the virtual environment to increase training accessibility among the emerging rural workforce. This study aimed to understand the impact of the virtual learning environment on interprofessional simulation (IPS) outcomes among social work (MSW) and nursing (MSN) students. The study sample ( N =127) was composed of MSW ( n =48) and MSN ( n =79) students at a private university in the United States. The mixed-methods study utilized 1. independent samples t-tests to examine differences in students' interprofessional teaming behaviors, measured by the Performance Assessment Communication and Teamwork (PACT), after participation in a virtual interprofessional simulation (IPS) versus a traditional, in-person IPS; and 2. independent samples t-tests and qualitative thematic analysis to explore the feasibility and acceptability of the IPS among the virtual and in-person groups via the PACT and a satisfaction survey. Both IPS featured a case contextualized to take place in an underserved, rural area. Findings indicate virtual and in-person IPS provide comparable preparation in interprofessional team functioning and performance essential to interprofessional care. Students found the IPS feasible, acceptable, and were satisfied with the experience independent of platform. Virtual IPS experiences mitigate barriers to rural workforce development. Providing training in interprofessional practice using virtual platforms stands to benefit individuals in geographically-isolated communities.