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This review will focus on the methods, efficacy and effectiveness, findings, and dissemination of mental health interventions that identify how African American boys and men are diagnosed and treated in therapeutic settings for symptoms of depression, anxiety, and post-traumatic stress.

The end-of-life period of individuals with Alzheimer disease and related dementias receiving home health care (HHC) is understudied. We sought to describe characteristics of HHC patients with Alzheimer disease and related dementias at risk of death within a year, based on clinician assessment. We conducted a secondary data analysis of a 5% random sample of the Outcome and Assessment Information Set data set for the year 2017. We used Outcome and Assessment Information Set-C item M1034 to identify HHC patients with overall status of progressive condition leading to death within a year. Multivariable logistic regression model was used to examine the association between sociodemographic, functional, clinical, and caregiving factors and likelihood of decline leading to death within a year, as identified by HHC clinicians. Clinician perception of decline leading to death within a year was higher for Whites (vs Blacks or Hispanics) (odds ratio [OR], 0.74 [95% confidence interval (CI), 0.69-0.80], and OR, 0.63 [95% CI, 0.57-0.69], respectively). Factors associated with increased odds of decline leading to death within a year included daily pain (OR, 1.11 [95% CI, 1.06-1.17]), anxiety daily or more often (OR, 1.58 [95% CI, 1.49-1.67]), shortness of breath (OR, 1.45 [95% CI, 1.34-1.57]), use of oxygen (OR, 1.60 [95% CI, 1.52-1.69]), disruptive behavior (OR, 1.26 [95% CI, 1.20-1.31]), and feeding difficulty (OR, 2.25 [95% CI, 2.09-2.43]). High symptom burden exists among HHC patients with Alzheimer disease and related dementias identified to have a status of decline leading to death within a year.

Millions of older Americans receive nurse practitioner (NP)-provided home based primary care (HBPC). Little is known about how state scope-of- practice (SOP) laws may impact use of NP-home visits. Using 2017 Centers for Medicare and Medicaid Services Provider Utilization and Payment Data Public Use File (PUF), we examined the impact of state SOP laws on the use of NP-home visits. The PUF file was merged with the 2017 American Community Survey to assess area-level median income. Over 4.4 million home visits were provided to 1.6 million Medicare beneficiaries. NPs represented the largest share of providers (47.5%). In states with restricted SOP laws, compared to NPs, physicians and physician assistants had higher odds of providing HBPC. In states with reduced SOP laws, compared to NPs, physicians and PAs had decreased odds of providing HBPC. Our study provides evidence that SOP restrictions are associated with decreased utilization of NP-provided HBPC.

Utilization of hospice for end-of-life care is known to be lower among racial and ethnic minority groups than among White populations when controlling for other socioeconomic factors. Certain patient, provider, and community characteristics may influence home-hospice use. We sought to identify patient, provider, and community factors associated with home-hospice use. Our final analytic sample included 1,208,700 hospice patients who received home-hospice from 2,148 Medicare-certified hospice providers in 2016. We found that an increase in the proportion of hospice patients with a primary diagnosis of dementia decreased the odds that home-hospice was provided (OR = 1.42, 95% CI = 1.36-1.48). Patients who received hospice care from a provider with a higher proportion of dually enrolled patients were less likely to receive home-hospice (OR = 1.42, 95% CI = 1.36-1.48) and hospices located in ZIP-codes with higher proportion of Hispanic resident were less likely to provide home-hospice (OR = 1.00, 95% CI = 0.99-0.99). Additional research is needed to clarify the mechanisms underlying these associations.

Underrepresented minority (URM) students in nursing education are essential to address health disparities.To determine barriers and facilitators to success among URM students in nursing education.CINAHL, PubMed, Embase, and PsycINFO were searched for English language research studies published between 1980 and 2020, which focused on barriers and facilitators to success in nursing education in the United States among URM students. Using PRISMA guidelines, 2 reviewers independently reviewed and appraised the quality of relevant articles.Among the 4435 articles surveyed, 14 met inclusion criteria. Most studies were focused on Black and Hispanic/Latinx students, and 71% were qualitative. Barriers included social isolation, caregiving demands, lack of mentorship, and inadequate financial resources. Facilitators included mentorship, positive class and curriculum, family support, financial support, and diverse/inclusive learning environments.URM students face complex barriers to success in nursing education. Addressing these barriers requires a multilevel approach.

Background There are important racial and geographic disparities linked with obesity and diabetes in the USA. Latinx residing in rural areas face a unique combination of factors that can exacerbate existing healthcare disparities, increasing the prevalence of diabetes. Methods Qualitative study using focus groups was carried out between November 2014 and February 2015. The six focus groups were evenly split between Miami (Miami-Dade) and Pensacola (Escambia County) both in Florida. A total of 57 Latinx, 40 years and older, were recruited for a 60-minute session. Baseline demographic and clinical information were collected using a questionnaire before starting the focus group. Open-ended questions recorded participants’ perceptions about obesity and diabetes and barriers to health care. Theme analysis was conducted for each question and across the groups. Results While most Hispanics understood that diabetes is a serious disease, neither those in Miami nor Escambia understood the difference between type 1 and 2 diabetes. Those in Miami had more knowledge about its long-term effects and expressed less language, communication and cultural barriers compared to those in Escambia. Conclusions There is a need to promote culture-appropriate health education programs geared towards raising awareness about diabetes in both communities but especially in rural communities.

Background The World Health Organisation (WHO) recommends skin-to-skin contact at birth as part of the essential newborn care processes that can help improve breastfeeding behaviours in new mothers. In 2019 Nigeria had the highest number of infant mortalities (270,000 infant deaths), second only to India (522,000 infant deaths). Consequently, the possible benefits of skin-to-skin contact and healthy breastfeeding behaviours to both mother and child cannot be overemphasised. This study seeks to understand the rate of skin-to-skin contact post-birth and how this affects early breastfeeding initiation, breastfeeding duration, and exclusive breastfeeding among Nigerian women. It also seeks to understand if the place of delivery or internet access affects the associations between skin-to-skin contact and breastfeeding behaviours. Methods Data from the Demographic and Health Survey (2018) on Nigerian women were analyzed, and 19,328 women were included in this study. The association between skin-to-skin contact post-birth (independent variable) and breastfeeding initiation, exclusive breastfeeding, and breastfeeding duration (dependent variables) were analyzed with multivariable logistic regression models adjusted for known confounders. The modifying effects of place of delivery and internet use were also assessed. Results Nearly 13% of Nigerian women experienced skin-to-skin contact post-birth. The odds of exclusive breastfeeding were higher for women who experienced skin-to-skin contact with their newborns, compared to those that did not (odds ratio, OR=1.24, 95% confidence interval, CI=1.13-1.36). Conversely, the odds of initiating breastfeeding within the first hour of birth (OR=0.87, 95% CI=0.79-0.96) were lower in women who experienced skin-to-skin contact post-birth. There was no association between skin-to-skin contact and breastfeeding duration. Delivering their baby in private hospitals modified the association between skin-to-skin contact and early breastfeeding initiation (OR=3.27, 95% CI=2.33-4.60, P Conclusions In Nigerian women, skin-to-skin contact post-birth is associated with some breastfeeding behaviours (early initiation and exclusive breastfeeding). However, associations between skin-to-skin contact and breastfeeding behaviours of early breastfeeding initiation and breastfeeding duration may be modified by the place of delivery. Therefore, health interventions to increase skin-to-skin contact practices should target skilled health providers, particularly in public hospitals.