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The purpose of the current study is to describe the demographic, behavioral, and psychosocial characteristics of adolescent and caregiver lay health advisers (LHAs) participating in an intervention designed to reduce risk behaviors among rural African-American adolescents.Teach One, Reach Oneintegrates constructs from the Theory of Planned Behavior and Social Cognitive Theory. It acknowledges that changing the sexual behaviors of African-American adolescents requires changing one's knowledge, attitudes, normative beliefs about the behavior of peers, and self-efficacy regarding adolescent sexual behavior, parent–teen communication about sex, and healthy dating relations among adolescents. Study participants completed baseline questionnaires assessing demographics and psychosocial determinants (knowledge, attitudes, perceived social norms, and self-efficacy) of sexual behaviors. Sixty-two adolescent and caregiver dyads participated. Caregivers included biological parents, legal guardians, or other parental figures. Strengths and areas in need of improvement were determined using median splits. Few adolescents had initiated sex. Their strengths included high levels of open parent–teen communication; positive attitudes and normative beliefs regarding both sex communication and healthy dating relationships; and high knowledge and self-efficacy for healthy dating behaviors. Areas needing improvement included low knowledge, unfavorable attitudes, poor normative beliefs, and low self-efficacy regarding condom use. Caregiver strengths included positive attitudes, normative beliefs, and self-efficacy for sex communication; positive attitudes and self-efficacy for condom use; and low acceptance of couple violence. Areas needing improvement included low levels of actual communication about sex and low knowledge about effective communication strategies and condom use. The current study highlights the value of assessing baseline characteristics of LHAs prior to intervention implementation, as it enables a better understanding of the key characteristics necessary for planning and implementing interventions, as well as engaging in targeted training activities. [ABSTRACT FROM PUBLISHER]

Objective: To pilot test a culturally specific and developmentally appropriate curriculum for African-American college students that included self and family assessment to increase awareness of their risk of cardiovascular disease (CVD). Methods: Students were recruited from a historically Black university to participate in small group workshops focusing to increase their knowledge of their family history of CVD as well as reducing CVD risks. Focus groups were conducted to determine the effectiveness and ways to improve to the intervention. Results: Positive findings were found regarding program efficacy, increased understanding of their family history and strategies to reduce their own risk of CVD. Conclusion: Small group experiential workshop approach can be effective in helping African- American college students understand risk and establish healthy heart habits aimed at decreasing risk of coronary heart disease. [ABSTRACT FROM AUTHOR]

Recruiting minorities, particularly older African Americans, can be quite challenging. The literature suggests that having a research team member who resembles the population of interest is imperative. However, such strategies are not always feasible or successful. This paper presents the challenges and eventual success in recruiting African American grandmothers who were the primary caregivers for children in rural Arkansas to participate in a study on diabetes. The approach included adding team members from the community, increasing project visibility, giving back to the community, and providing study findings. Results indicate that a diverse research team can ensure the inclusiveness needed to develop sustainable interventions and to eliminate health disparities in this population. Allied health programs should teach future researchers about the legacy of unethical treatment of minorities in research and that, by increasing their presence in the community, they may be able to alleviate health challenges. [ABSTRACT FROM AUTHOR]

In this paper we discuss the concept of leadership as a personal capability, not contingent on one's position in a hierarchy. This type of leadership allows us to reframe both the care-giving and organizational roles of nurses and other front-line clinical staff. Little research has been done to explore what leadership means at the point of care, particularly in reference to the relationship between health care practitioners and patients and their family caregivers. The Adaptive Leadership framework, based on complexity science theory, provides a useful lens to explore practitioners' leadership behaviors at the point of care. This framework proposes that there are two broad categories of challenges that patients face: technical and adaptive. Whereas technical challenges are addressed with technical solutions that are delivered by practitioners, adaptive challenges require the patient (or family member) to adjust to a new situation and to do the work of adapting, learning, and behavior change. Adaptive leadership is the work that practitioners do to mobilize and support patients to do the adaptive work. The purpose of this paper is to describe this framework and demonstrate its application to nursing research. We demonstrate the framework's utility with five exemplars of nursing research problems that range from the individual to the system levels. The framework has the potential to guide researchers to ask new questions and to gain new insights into how practitioners interact with patients at the point of care to increase the patient's ability to tackle challenging problems and improve their own health care outcomes. It is a potentially powerful framework for developing and testing a new generation of interventions to address complex issues by harnessing and learning about the adaptive capabilities of patients within their life contexts.