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Background: In healthcare, family engagement has been recognized as critical to improved nursing care and outcomes. However, the practice of family engagement in corrections is unknown, despite the large amount of nursing care delivered there., Purpose: The study's aim was to describe correctional nurses' perceptions of family engagement and the extent to which it is practiced., Method: A qualitative descriptive study design was used, composed of semistructured interviews. Thematic analysis was conducted, including line-by-line coding., Discussion: The main themes of the study were: (a) Family engagement is rare, and (b) Systems friction which describe the lack of family engagement in correctional nursing practice, and the need to balance advocating for patients while maintaining a collegial relationship with correction staff., Conclusion: Despite the lack of family engagement in correctional nurses' practice, most participants felt that family engagement would be beneficial for incarcerated patients but would require changes to institutional policies., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Qualitative studies have examined the experiences of subjective cognitive dysfunction in specific populations or specific disease stages, but there has not yet been a systematic synthesis and evaluation of findings related to perceptions of subjective cognitive dysfunction in nondementia-related chronic illnesses., Objective: The aim of this study was 2-fold: (1) to undertake a systematic review of experiences of subjective cognitive dysfunction in people with nondementia-related chronic disease and (2) to develop an explanatory framework to describe the experiences of living with subjective cognitive dysfunction., Methods: Four databases were systematically searched for studies on subjective cognitive dysfunction up to June 2023. Qualitative synthesis was conducted on the final sample (N = 25) using Sandelowski's adaptation of Nobilt and Hare's reciprocal transactional analysis method. Critical appraisal was completed using the Critical Appraisal Skills Programme checklist., Results: Through constant comparison of key concepts, findings were organized within 4 interrelated themes that informed a conceptual explanatory model of adapting to living with subjective cognitive dysfunction: (1) symptoms, (2) health care, (3) perceptions of self, and (4) relationships. Participants highlighted how subjective cognitive dysfunction affected interactions in health care settings and involved other symptoms that in turn complicated meaning, self-enhancement, and mastery., Conclusions: Our model of the process of adapting provides a new way to conceptualize cognitive dysfunction in chronic illness and suggests opportunities for health care professionals to support patients and their families. The results highlight the need for more research to better understand the role of subjective cognitive dysfunction in nondementia-related chronic illnesses.The review protocol was registered in PROSPERO (CRD42021231410)., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Given the dearth of resources to support rural public health practice, the solutions in health analytics for rural equity across the northwest dashboard (SHAREdash) was created to support rural county public health departments in northwestern United States with accessible and relevant data to identify and address health disparities in their jurisdictions. To ensure the development of useful dashboards, assessment of usability should occur at multiple stages throughout the system development life cycle. SHAREdash was refined via user-centered design methods, and upon completion, it is critical to evaluate the usability of SHAREdash., Objective: This study aims to evaluate the usability of SHAREdash based on the system development lifecycle stage 3 evaluation goals of efficiency, satisfaction, and validity., Methods: Public health professionals from rural health departments from Washington, Idaho, Oregon, and Alaska were enrolled in the usability study from January to April 2022. The web-based evaluation consisted of 2 think-aloud tasks and a semistructured qualitative interview. Think-aloud tasks assessed efficiency and effectiveness, and the interview investigated satisfaction and overall usability. Verbatim transcripts from the tasks and interviews were analyzed using directed content analysis., Results: Of the 9 participants, all were female and most worked at a local health department (7/9, 78%). A mean of 10.1 (SD 1.4) clicks for task 1 (could be completed in 7 clicks) and 11.4 (SD 2.0) clicks for task 2 (could be completed in 9 clicks) were recorded. For both tasks, most participants required no prompting-89% (n=8) participants for task 1 and 67% (n=6) participants for task 2, respectively. For effectiveness, all participants were able to complete each task accurately and comprehensively. Overall, the participants were highly satisfied with the dashboard with everyone remarking on the utility of using it to support their work, particularly to compare their jurisdiction to others. Finally, half of the participants stated that the ability to share the graphs from the dashboard would be "extremely useful" for their work. The only aspect of the dashboard cited as problematic is the amount of missing data that was present, which was a constraint of the data available about rural jurisdictions., Conclusions: Think-aloud tasks showed that the SHAREdash allows users to complete tasks efficiently. Overall, participants reported being very satisfied with the dashboard and provided multiple ways they planned to use it to support their work. The main usability issue identified was the lack of available data indicating the importance of addressing the ongoing issues of missing and fragmented public health data, particularly for rural communities., (©Elizabeth Heitkemper, Scott Hulse, Betty Bekemeier, Melinda Schultz, Greg Whitman, Anne M Turner. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 05.06.2024.)

Objective: To create and evaluate a public health informatics tool, Florence, for communicating information to the public., Materials and Methods: This user-centered design study included 3 phases: (1) an interview and survey study with public health practitioners to assess needs for creating infographics; (2) the application of assessment findings and public health-motivated design guidelines to the design and development of a public health-specific infographic design tool; and (3) a feasibility and usability study to evaluate the feasibility and usability of the tool., Results: In phase 1, participants noted the importance of tailoring infographics to an audience and wanted flexible tools along with design guidance to help make fewer design decisions. In phase 2, we developed a prototype tool with: (1) layout and functionality familiar to PH users, (2) quick and intuitive ways to add and modify data in visualizations, and (3) health-focused visual elements. In phase 3, participants found Florence to be usable, providing an intuitive and straightforward experience, and that the focus on public health was useful., Discussion: Based on needs assessments and existing literature, we created Florence along with public health practitioners to address their domain specific needs, ultimately leading to a tool that participants in our study deemed useful. Future research can build on our work to develop user-centered tools to meet their needs., Conclusion: Infographics are important for public health communication. Creating user-centered solutions to address the unique needs of public health can support communication efforts., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Aims: To identify the barriers and facilitators to healthcare for people without documentation status., Design: We conducted a systematic integrative literature review following the Whittemore and Knafl methodology., Methods: Literature search was conducted to identify studies addressing barriers or facilitators to healthcare for people without documentation status in the United States between 2012 and 2022. Studies were critiqued for quality, with results analysed thematically using the social-ecological model., Data Sources: Searches were conducted in PubMed, PAIS, Web of Science, CINAHL and Psych Info in October 2022., Results: The review incorporated 30 studies (19 qualitative and 11 quantitative). People without documentation status encountered numerous healthcare barriers such as intrapersonal (lack of financial resources and health insurance, fear), interpersonal (language and cultural discrepancies, discrimination), community (bureaucratic requirements, anti-immigrant rhetoric) and policy-related barriers. Conversely, linguistically and culturally competent care, empathetic and representative staff, health navigators, safety-net clinics and supportive federal policies emerged as key facilitators., Conclusion: These findings illuminate the complex healthcare disparities experienced by people without documentation status and underscore facilitators enhancing care accessibility. Future research is needed to explore interventions to increase access to care for this population., Impact: This paper provides a comprehensive examination of the complex barriers and facilitators to healthcare for people without documentation status in the United States. The findings support the value of universal healthcare access, a priority of the World Health Organization, and can inform healthcare policies and practices worldwide., Reporting Method: The review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework., Patient or Public Contribution: No patient or public contribution was needed., Trial and Protocol Registration: The study protocol was registered with the PROSPERO database (registration number: CRD42022366289)., (© 2023 John Wiley & Sons Ltd.)

People with intellectual and developmental disabilities (IDD) experience elevated risk for poor health and social outcomes in adulthood and are at risk for experiencing homelessness and housing instability. Although the exact prevalence of IDD among homeless populations is unknown, a small body of literature related to the intersection of IDD and homelessness suggests differential health needs and service use patterns, with a need for targeted health and social services. In this study, we explore the perceptions and experiences of 18 homeless or disability service providers about (a) their clients at the intersection of IDD and homelessness and (b) their role and the services provided at the intersection of IDD and homelessness. Participants struggled to provide appropriate, accessible services for this population, owing to lack of training and awareness of specific needs, fragmented systems, and inadequately funded healthcare and housing support. Our findings also reveal that clients at this intersection have high contact with public systems, which places them at risk for losing their right to self-determination. Recommendations center on systems transformation to facilitate the ability of providers to collaborate and to make data-driven decisions to deliver person-centered care.

Context: Rural public health personnel serve communities that have been particularly susceptible to COVID-19 and yet faced the pandemic with far less well-resourced capacity than their urban counterparts. A critical aspect of addressing local health inequities is access to high-quality population data and the capacity to effectively use data to support decision making. However, much of the data required to investigate inequities are not readily available to rural local health departments and the tools and training to analyze data are often lacking., Program: The purpose of our effort was to explore rural data challenges related to COVID-19 and provide recommendations for improving rural data access and capacity ahead of future crises., Implementation: We gathered qualitative data in 2 phases, more than 8 months apart, from rural public health practice personnel. Initial data were gathered in October-November 2020 regarding rural public health data needs during the COVID-19 pandemic and then to later identify whether the same findings held true in July 2021 or whether access to and capacity to use data to address the pandemic and related inequities improved as the pandemic progressed., Evaluation: In our 4-state exploration focused on access and use of data among rural public health systems to promote health equity in the Northwest United States, we found tremendous and ongoing unmet data needs, challenges with communicating data, and a lack of capacity to meet this public health crisis., Discussion: Recommendations for addressing these challenges include increasing dedicated resources specifically to rural public health systems, improving data access and infrastructure, and providing dedicated data-related workforce development., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Context: The COVID-19 pandemic made the long-standing need for a national uniform financial reporting standard for governmental public health agencies clear, as little information was available to quantify state and local public health agencies' financial needs during the pandemic response. Such a uniform system would also inform resource allocation to underresourced communities and for specific services, while filling other gaps in practice, research, and policy making. This article describes lessons learned and recommendations for ensuring broad adoption of a national Uniform Chart of Accounts (UCOA) for public health departments., Program: Leveraging previous efforts, the UCOA for public health systems was developed through collaboration with public health leaders. The UCOA allows state and local public health agencies to report spending on activities and funding sources, along with practice-defined program areas and capabilities., Implementation: To date, 78 jurisdictions have utilized the UCOA to crosswalk financial information at the program level, enabling comparisons with peers., Evaluation: Jurisdictions participating in the UCOA report perceptions of substantial up-front time investment to crosswalk their charts of accounts to the UCOA standard but derive a sense of valuable potential for benchmarking against peers, ability to engage in resource allocation, use of data for accountability, and general net positive value of engagement with the UCOA., Implications for Policy and Practice: The UCOA is considered a need among practice partners. Implementing the UCOA at scale will require government involvement, a reporting requirement and/or incentives, technical assistance, financial support for agencies to participate, and a means of visualizing the data., Competing Interests: The authors declare that they have not conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: This study examined whether distinct factors exist among public health skills, measured through the Public Health Workforce Interests and Needs Survey (PH WINS). Understanding how workforce training needs group is important for developing targeted and appropriate public health workforce training sessions., Design: Exploratory factor analysis was used to examine public health skills among tier 1 staff (nonmanagers) and a combined group of tier 2 and 3 staff (managers and executives)., Setting: Data for this study come from the 2017 PH WINS, which assessed public health workforce perceptions of training needs, workplace environment, job satisfaction, perceptions about national trends, and demographics. The analysis included 22 items., Participants: All public health staff in participating agencies were eligible to complete the survey. The national data set included participants from 47 state health agencies, 26 large local health departments (LHDs), and 71 mid-sized LHDs across all 10 Health and Human Services regions in the United States (including LHDs from all states). The analytic sample was n = 9630 in tier 1, n = 4829 in tier 2, and n = 714 in tier 3 staff., Main Outcome Measure: Three factors were identified within the skills portion of PH WINS, using exploratory factor analysis. To interpret retained factors, the following parameters were used: factor loadings greater than 0.4, factor cross-loadings less than 0.4 or higher than loadings on other factors, and communalities greater than 0.5., Results: Factors included (1) data and systems thinking, (2) planning and management, and (3) community collaboration, with slight variation in item loadings between tier 1 and tier 2 and 3 staff analyses., Conclusion: This study was the first known factor analysis of the training needs and workforce skills portion of PH WINS in the published literature. This study advances our conceptualization of public health workforce skills and has the potential to shape future critical workforce training development., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Recent frameworks, models, and reports highlight the critical need to address social determinants of health for achieving health equity in the United States and around the globe. In the United States, data play an important role in better understanding community-level and population-level disparities particularly for local health departments. However, data-driven decision-making-the use of data for public health activities such as program implementation, policy development, and resource allocation-is often presented theoretically or through case studies in the literature. We sought to develop a preliminary model that identifies the factors that contribute to data-driven decision-making in US local health departments and describe relationships between them. Guided by implementation science literature, we examined organizational-level capacity and individual-level factors contributing to using data for decision-making related to social determinants of health and the reduction of county-level disparities. This model has the potential to improve implementation of public health interventions and programs aimed at upstream structural factors, by elucidating the factors critical to incorporating data in decision-making., (© 2022 John Wiley & Sons Ltd.)

A scoping review was conducted to present the state of the science regarding the health and health-related quality of life (HRQOL) effects of having a family member in contact with the criminal legal system (CLS). The review examined how the following have been studied: 1) types of family relationships, 2) the point of CLS contact, 3) mental health outcomes, 4) physical health outcomes, and 5) HRQOL outcomes. The final sample of 40 studies was largely secondary analyses of datasets (93%; n=37) that investigated a parent-child relationship (78%; n=31). Incarceration was the most frequently measured point of CLS contact (85%; n=34). Mental health outcomes were measured in 68% of the studies (n=27). Physical health outcomes were measured in 28% of the studies (n=11). Health-related quality of life outcomes were included in half of the studies (50%; n=20). Study findings indicate exposure to the CLS through a family member is associated with poorer health and HRQOL outcomes.

The aim of the current study was to explore relationships among perceived cognitive function, glucose variability, and self-management in older adults with type 2 diabetes mellitus (T2DM). A mixed methods design was used with data from: (a) questionnaires on perceived cognitive function and diabetes self-management; (b) continuous glucose monitoring (CGM) reports; and (c) semi-structured interviews. Thirty adults with T2DM (47% female; mean age = 68.5 [ SD = 5.2] years) participated. Those who exercised more days per week had more stable glucose. Those who reported fewer days of diet adherence had more hypoglycemia. Participants who reported higher levels of memory dissatisfaction exhibited higher levels of glucose variability. Findings point to the potential of glucose variability as a target to reduce the effect of diabetes on cognitive function. Instruction in recognition of glucose patterns found via CGM can be integrated into self-management education to improve self-management and subsequent glucose control and cognitive function. [ Research in Gerontological Nursing, 15 (4), 203-212.].

We present an analysis of challenges facing public health nursing faculty members (PHNF) in the United States and their broader societal implications. The COVID-19 pandemic has exacerbated these challenges, making them untenable. Current academic structures-influenced by the broader sociopolitical climate-are problematic for PHNF: they disincentivize PHNF from researching social determinants of health and public health systems, teaching systems-level content that may be deemed "controversial" and that is not included on licensure exams, and engaging in service through advocacy and community partnerships. The fault lines within health care, public health systems, and higher education indicate that it is time to reevaluate how to incentivize socially just and equitable outcomes. Toward this goal, we propose that collective action and systemic change, including the perspectives of PHNF, is needed to better realize our shared goals. The analysis serves as a catalyst for conversations about academic structures, health care systems, the role of public health, and the kind of society we envision for ourselves and future generations. ( Am J Public Health . 2022;112(S3):S314-S320. https://doi.org/10.2105/AJPH.2022.306819).

Background: As the population ages and more people are affected by multiple chronic conditions, the prevalence of Peripheral Neuropathy (PN) has also rapidly increased. This swift rise in PN leaves clinicians and patients challenged by a lack of consistent diagnosis and treatment guidelines., Purpose: To assist those affected by PN, it is imperative to understand the breadth of symptoms, experiences, and factors related to the quality of life. The primary aims of this study are to (1) characterize the symptoms of PN in a nationwide sample; (2) discern differences in symptom clusters, given perceived causes of PN; and (3) identify significant physiological symptoms related to the quality of life for people with PN., Methods: An online survey of people in online PN support groups. Participants were recruited primarily via an open request sent to recipients of web-based communications from nationally recognized online PN support groups. Inclusion criteria were as follows: Self-reported diagnosis of PN, ability to read English or Spanish, residence in the U.S., and age ≥ 18 years., Results: A total of 608 individuals with PN were included in the analysis. This sample represents 49 U.S. states and the District of Colombia; 221 were male and 387 female. Their disease severity and etiology were similar to previously reported information on this population, with 53.3% of respondents suffering from PN without a known cause. Among known causes, diabetes was the most common (19.6%), followed by chemotherapy (6.9%) and autoimmune diseases (3.6%). Factors affecting the quality of life among people with PN included lower extremity mobility, upper extremity mobility, sleep disturbance, depressive symptoms, and patient activation., Competing Interests: None of the authors disclose any conflicts of interest. The study was supported by one research grant from the Neuropathy Alliance of Texas and two grants from the National Institute of Nursing Research (P30, NR015335), the Center for Transdisciplinary Collaborative Research in Self-management Science at The University of Texas at Austin School of Nursing, and Precision Health Intervention Methodology Training in Self-Management of Multiple Chronic Conditions. (NIH/NR 1T32 NR019035). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other supporters.

Objective: The objectives of this review are to (1) describe the state of the science of patient activation interventions for the self-management of chronic conditions; (2) identify effective intervention elements for improving patient activation; and (3) compare intervention effectiveness across chronic conditions., Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). PubMed, CINAHL, and Web of Science databases were searched., Results: Thirty-two articles published between 2005 and 2019 were identified with intervention elements of self-management, disease management, and education. Meta-analysis of a subset of seven randomized controlled trials (n = 7) that used the 13-item version of the Patient Activation Measure with data collection points at 6 months demonstrated that patient activation did not change significantly in comparison with controls (MD = 0.25, 95 % CI = 0.02-0.47)., Conclusion: Most interventions reported significant improvement in patient activation and were linked to tasks such as regular exercise and monitoring glucose. However, the meta-analysis of RCTs did not confirm these findings., Practice Implications: Patient activation can be assessed and addressed uniformly across all chronic conditions to improve patient engagement in care., Competing Interests: Declaration of Competing Interest The authors report no declarations of interest., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Purpose: The study purpose was to compare dissemination of PhD dissertation research by dissertation format: traditional (five-chapter document providing a complete and systematic account of the PhD research) versus an alternate (substudy [document containing three smaller studies but not written as stand-alone manuscripts] or publication [document containing three or more related manuscripts intended for submission or published in a peer-reviewed journal]) format., Design: A retrospective study of all PhD dissertations (1999-2019) from one research intensive school of nursing., Methods: Following identification of graduates via the school's PhD database, we searched ProQuest and PubMed databases for the dissertation and first authored peer-reviewed publications of each graduate to determine dissertation format, study design, timing and number of dissertation research publications, and inclusion of dissertation sponsor in authorship. Data were analyzed using descriptive statistics and Wilcoxon rank sum tests., Findings: Of 113 graduates, 80 (70.8%) employed a traditional format, with the remaining graduates structuring dissertations using an alternate (substudy [n = 12], publication [n = 21]) format. Of those using the traditional format, 33 graduates (41.3%) never published dissertation research findings in a peer-reviewed journal. For those who published their dissertation research in a peer-reviewed journal, time to first publication was 1.4 ± 2.1 years (median 1.6 years) following degree conferral. In contrast, all graduates who utilized alternate formats published one or more components of their dissertation research with shorter time to first published manuscript (-0.6 ± 1.1 years; median -0.5 years; p < .001). Number of peer-reviewed publications was higher for those who utilized an alternate format compared to the traditional format (2.9 ± 1.5 [median 3.0] vs. 1.8 ± 1.1 [median 1.0], p = .001). Acknowledgment of the sponsor's contribution via publication authorship was higher for those using an alternate format compared to the traditional format (100% vs. 70.2%)., Conclusions: Number and timeliness of peer-reviewed publications stemming from dissertation research was higher for PhD graduates who utilized an alternate dissertation format. Alternate dissertation formats should be encouraged by PhD programs as one means to improve dissemination of PhD nursing research., Clinical Relevance: Dissemination of PhD research through peer-reviewed publications promotes the continued development of nursing science to inform nursing practice and advances the career trajectory of PhD graduates., (© 2019 Sigma Theta Tau International.)

Acute respiratory tract infections (ARI) are a major burden in pediatric long-term care. We analyzed the financial impact of ARI in 2012-2013. Costs associated with ARI during the respiratory viral season were ten times greater than during the non-respiratory viral season, $31 224 and $3242 per 1000 patient-days, respectively (P < 0·001). ARI are burdensome for pediatric long-term care facilities not only because of the associated morbidity and mortality, but also due to the great financial costs of prevention., (© 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)