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The purpose of this study was to explore school nurse perceptions of the nurse-family relationship in the care of elementary students with asthma and attention-deficit hyperactivity disorder (ADHD). A cross-sectional survey design was used to collect data from 97 school nurses in Minnesota. The Family Nursing Practice Scale measured nurses' perceptions of their family nursing practice. Bivariate analyses were conducted to compare scores by factors at the community, school, nurse, and child levels. Results suggest that school nurses have positive appraisals of their family nursing practice, though scores were generally lower in the context of ADHD compared to asthma. Participants with a graduate degree reported greater skill in working with families, whereas novice nurses reported less confidence working with families and less comfort initiating family involvement in care. Results suggest that interventions at the nurse and school levels may support enhanced family nursing practice by nurses caring for students with chronic conditions.

Parents can play an important role in reducing their children's risk for teenage pregnancy and sexually transmitted infections, and in promoting sexual health during adolescence. The purpose of this study was to explore communication between parents, family members and young people and how it influences their romantic and sexual behaviours. Semi-structured interviews were conducted with 28 African American, American Indian, Euro-American and Latina women aged 19-29 years. Findings clustered into five themes. First, mothers were often the primary source of reproductive education. Second, fathers provided valuable guidance, although they were not the first source of information. Third, parental expectations influenced young people's sexual behaviours both positively and negatively. Fourth, aunts, uncles and grandparents were trusted sources of advice for personal discussions. Fifth, over one-third of participants perceived that there was no adult available to them during their teenage years for discussions about romance. Sex educators can encourage and guide parents to discuss romantic and sexual issues with young people as a way to support their young people's healthy sexual and romantic behaviours. Health and sex educators should also identify young people lacking support and encourage stronger relationships with family including fathers and extended family members.

Background: Initiation of sexual intercourse during early adolescence is a known risk factor for teen pregnancy and sexually transmitted infections. Purpose: To examine young women's stories describing peer in?uences on their romantic and sexual decisions and behavior during early adolescence. Methods: Semistructured ethnographic interviews were conducted with 28 African American, American Indian, Euro-American, and Latina females ages 19 to 29 years. Results: Four common themes (patterns) emerged. First, most participants belonged to a same-sex peer group in early adolescence, many participated in mixed sex groups, and a small number had no peer group. Second, romantic relationships were discussed with peers more than with adults. Third, early adolescent romantic behavior commonly led to early initiation of sexual intercourse with negative emotional impacts. Fourth, participants cautioned teens about romantic involvement during early adolescence. Discussion: The findings suggest that mixed-sex peer group affiliation was associated with delayed dating. Older peers and social isolation were associated with riskier sexual behaviors. Early sexual initiation frequently led to negative experiences. Translation to Health Education Practice: Health educators and health care providers are encouraged to assess young adolescents' peer involvement, encourage prosocial mixed-sex peer activities, and provide guidance to parents about early adolescent development and the importance of monitoring their young adolescent children's activities to avoid potentially dangerous sexual situations. (Contains 2 tables.)

Objective: To describe aspects of the social context that low-income, urban African American young women articulate as having influenced social messages they received during adolescence about pregnancy timing and childbearing. Methods: Individual interviews were conducted with 20 African American young women ages 18-22. Results: Findings clustered into 5 themes: first sex; getting ready and getting it over with; the path for African American girls; gender expectations: insecurity and independence; living into a future; and living in a context of instability and uncertainty. Conclusions: Findings portray a complex relationship between social context, social messages, and decisions about pregnancy timing and childbearing.

Effective care coordination is a key quality and safety strategy for populations with chronic conditions, including children with medical complexity (CMC). However, gaps remain in parent report of the need for care coordination help and receipt of care coordination help. New models must close this gap while maintaining family-centered focus. A three-armed randomized controlled trial conducted in an established medical home utilized an advanced practice registered nurse intervention based on Presler's model of clinic-based care coordination. The model supported families of CMC across settings using telephone only or telephone and video telehealth care coordination. Effectiveness was evaluated from many perspectives and this paper reports on a subset of outcomes that includes family-centered care (FCC), need for care coordination help and adequacy of care coordination help received. FCC at baseline and end of study showed no significant difference between groups. Median FCC scores of 18.0-20.0 across all groups indicated high FCC within the medical home. No significant differences were found in the need for care coordination help within or between groups and over time. No significant difference was found in the adequacy of help received between groups at baseline. However, this indicator increased significantly over time for both intervention groups. These findings suggest that in an established medical home with high levels of FCC, families of CMC have unmet needs for care coordination help that are addressed by the APRN telehealth care coordination model., Author(s): Rhonda G. Cady[sup.1] [sup.3] , Mary Erickson[sup.2] , Scott Lunos[sup.1] , Stanley M. Finkelstein[sup.1] , Wendy Looman[sup.1] , Margaret Celebreeze[sup.1] , Ann Garwick[sup.1] Author Affiliations: (1) University of Minnesota, [...]

Objectives. We examined the correlates of having ever had sexual intercourse among American Indians aged 13 to 18 years in Minnesota. Methods. To assess key environmental, social, and individual correlates of sexual experience, we analyzed data from 4135 American Indian youths who participated in the 1998 and 2001 Minnesota Student Surveys. Results. Forty-two percent of those aged 13 to 15 years and 69% of those aged 16 to 18 years reported that they had ever had sexual intercourse. Correlates of sexual experience varied by age and gender. School connections had the strongest negative associations with sexual experience in young girls, and living with a father had negative associations with sexual experience for younger, but not older, youths. Sexual experience was most strongly and positively associated with risk behaviors such as substance use, violence exposure, and violence perpetuation. Conclusions. The strongest correlates of sexual experience for American Indian youths were high-risk behaviors and exposure to violence. Future work is needed to develop and employ measures that reflect youth assets and that specifically reflect the experiences of American Indian youths.

Abstract Background To increase understanding of the healthcare transition (HCT) process for young people living with Juvenile Idopathic Arthritis (JIA) by examining: 1) the extent to which youth report discussing HCT topics with their rheumatologist and 2) the association between youth perceptions of autonomy support from their rheumatologist and HCT discussions. Methods Data are from an online survey of youth in the United States with rheumatologic conditions (n= 134). HCT discussion was measured by 4 questions from the National Survey of Children with Special Health Care Needs. Youth perception of autonomy support was measured using a validated 6-item scale. Results One third of the youth (33.7%) reported talking to their rheumatologist about transferring to adult medicine. Less than half (40.8%) of respondents talked with their rheumatologist about adult healthcare needs, and less than a quarter (22.0%) discussed acquiring health insurance as an adult. Nearly two-thirds of respondents (62.7%) reported that their rheumatologist usually/always encourages self-care responsibility. Multivariate analyses revealed significant associations between rheumatologist support for youth autonomy and HCT counseling. Conclusion The low frequency of HCT counseling reported indicates a continuing need to increase awareness among rheumatologist in the USA. The strong associations between rheumatologist’s support for youth autonomy and HCT counseling suggest that developmentally “in-tune” providers may deliver the best guidance about transition planning for youth living with arthritis.