Effects of Diabetes Self-Management Education in the Primary Care Setting on Self-Efficacy and Glycosylated Hemoglobin Levels Among Adults With Type 2 Diabetes Mellitus

Persons with uncontrolled type 2 diabetes, generally defined as having a hemoglobin A1c above target goal of 7% to 8%, have an increased risk for developing chronic diseases including renal disease, heart disease, strokes, and blindness. Lifestyle modifications play a significant role in mitigating these risks and improving glycemic control. The purpose of this evidence-based project (EBP) is to provide individualized diabetes self-management education to patients with type 2 diabetes to improve patient’s self-efficacy and glycemic control. This EBP project is a continuation of a previously completed EBP by Nishita Patolia, DNP, FNP (2020), using wider inclusion criteria and optional telehealth modality designed to reach a larger number of participants. Individualized education appointments, consisting of a 30-minute encounter and one week telephone follow up call were provided to participants. Educational content was guided by the American Association of Diabetes seven self-care behaviors (AADE7). Techniques of motivational interviewing and goal setting were implemented in educational appointments to reinforce these concepts. Hemoglobin A1c values were measured at baseline and at 3 months. Self-efficacy was measured pre- and post-intervention using the Stanford Patient Education Resource Center Self-Efficacy for Diabetes Questionnaire. A total of six participants completed the education, telephone follow up, and self-efficacy surveys. Of those participants, five also completed the follow up hemoglobin A1c lab. Fifty percent of participants had an improvement in self-efficacy and 60% of participants had a reduction in hemoglobin A1c values

An exploratory study of the relationship between academic library work experience and perceptions of leadership skill development relevant to academic library directorship

Though research into academic library director leadership has established leadership skills and qualities required for success, little research has been done to establish where in their career library directors were most likely to acquire those skills and qualities. This research project surveyed academic library directors at Carnegie-designated Master’s granting institutions about their previous library positions, and what skills and qualities they perceived to have exercised in those positions. Five research questions were assessed. RQ1: Which of the respondents’ last five positions previous to the directorship are most often represented in the path to the academic library directorship? RQ2: Which of the previous positions held by the respondents are perceived to have helped prepare directors the most for the qualities and skills required of the position? RQ3: Is the perception of library leadership skill and quality development equal across departmental experience? RQ4: What, if any position(s), appear to be the “gatekeepers” for academic librarian skill and competency development? RQ5: What are the skills most commonly perceived to be used in each department? Findings revealed that respondents perceived there to be great opportunities to exercise leadership qualities in previous positions, but few opportunities to develop more empirically measurable leadership skills. In addition, respondents perceived those skill development opportunities to be available only once working in the position of library director or in the Administration department of academic libraries

VCU-UNITE: Identifying Recognition Mechanisms for University-Community Engagement

The aims of the project were to determine what process would be appropriate to recognize significant contributions of university and community partners to joint community engagement projects. Our view was that several different award ceremonies exist in VCU, none of which are well attended and suggesting that this form of recognition may not be a high priority for participants. Thus, we sought to determine the awareness and extent of involvement of VCU faculty, staff and students in community engagement projects, and to find out what format of recognition process would be appealing to both university and community participants. We gathered this information through surveys and focus groups, analyzed the data and determined that university and community partners had differing views on what types of recognition would be desirous. Next, we designed a web portal through which nominations could be made by members of the university and by the community. We propose a streamlined nomination and online review process, leading to a quarterly award consisting of a letter of thanks from the Division of Community Engagement, and a photograph and narrative placed on the VCU website. Recipients of quarterly awards would automatically compete for an annual award, such as P&T credit or additional community leave time (university), or a scholarship, a plaque, or recognition at a VCU event (community)

The Administrative and Professional Faculty Experience at VCU

At a time when Virginia Commonwealth University (VCU) is striving to become a premier research institution, Administrative and Professional (A&P) Faculty are essential to the university’s ability to provide and sustain the quality educational programs that are the foundation of the academic enterprise. While essential, A&P Faculty are not always factored into University efforts to the same extent as instructional faculty. Recognizing that A&P Faculty represent a population diverse in educational background, professional focus, role, responsibility, and contribution, Team Our Time conducted a mixed methods study on the experience of A&P Faculty at VCU

The Harms of Screening: A Proposed Taxonomy and Application to Lung Cancer Screening

IMPORTANCE Making rational decisions about screening requires information about its harms, but high-quality evidence is often either not available or not used. One reason may be that we lack a coherent framework, a taxonomy, for conceptualizing and studying these harms. OBJECTIVE To create a taxonomy, we categorized harms from several sources: systematic reviews of screening, other published literature, and informal discussions with clinicians and patients. We used this information to develop an initial taxonomy and vetted it with local and national experts, making revisions as needed. RESULTS We propose a taxonomy with 4 domains of harm from screening: physical effects, psychological effects, financial strain, and opportunity costs. Harms can occur at any step of the screening cascade. We provide definitions for each harm domain and illustrate the taxonomy using the example of screening for lung cancer. CONCLUSIONS AND RELEVANCE The taxonomy provides a systematic way to conceptualize harms as experienced by patients. As shown in the lung cancer screening example, the taxonomy also makes clear where (which domains of harms and which parts of the screening cascade) we have useful information and where there are gaps in our knowledge. The taxonomy needs further testing and validation across a broad range of screening programs. We hope that further development of this taxonomy can improve our thinking about the harms of screening, thus informing our research, policy making, and decision making with patients about the wisdom of screening

Do psychological harms result from being labelled with an unexpected diagnosis of abdominal aortic aneurysm or prostate cancer through screening? A systematic review

Objective A potential psychological harm of screening is unexpected diagnosistextemdashlabelling. We need to know the frequency and severity of this harm to make informed decisions about screening. We asked whether current evidence allows an estimate of any psychological harm of labelling. As case studies, we used two conditions for which screening is common: prostate cancer (PCa) and abdominal aortic aneurysm (AAA).Design Systematic review with narrative synthesis.Data sources and eligibility criteria We searched the English language literature in PubMed, PsychINFO and Cumulative Index of Nursing and Allied Health Literature (CINAHL) for research of any design published between 1 January 2002 and 23 January 2017 that provided valid data about the psychological state of people recently diagnosed with early stage PCa or AAA. Two authors independently used explicit criteria to review and critically appraise all studies for bias, applicability and the extent to which it provided evidence about the frequency and severity of harm from labelling.Results 35 quantitative studies (30 of PCa and 5 of AAA) met our criteria, 17 (48.6 of which showed possible or definite psychological harm from labelling. None of these studies, however, had either appropriate measures or relevant comparisons to estimate the frequency and severity of psychological harm. Four PCa and three AAA qualitative studies all showed clear evidence of at least moderate psychological harm from labelling. Seven population-based studies found increased suicide in patients recently diagnosed with PCa.Conclusions Although qualitative and population-based studies show that at least moderate psychological harm due to screening for PCa and AAA does occur, the current quantitative evidence is insufficient to allow a more precise estimation of frequency and severity. More sensitive measures and improved research designs are needed to fully characterise this harm. In the meantime, clinicians and recommendation panels should be aware of the occurrence of this harm.Peer reviewe

Selection into medicine using interviews and other measures: Much remains to be learned

The objectives of this study were to identify the effectiveness of the panel admission interview as a selection tool for the medical program and identify improvements in the selection tools battery. Data from 1024 students, representing four cohorts of students were used in this study. Exploratory factor analysis using principal component analysis was used to identify underlying factors within the admission tools. A series of hierarchical linear regressions was employed to identify the predictability of performance in the medical program by the admission tools. Although the admission tools yielded low correlations with one another (r<.30), correlations between interview sub-scores were high (.435<r<.640). All interview sub-scores loaded on to a single factor explaining over 60% of the variance. The admission tools and the interview overall scores explained less than 13.5% and 3.8% (respectively) of the variance in the key outcome measures. We concluded that each admission tool measured different attributes, and suggest that admission interview procedures and the interview questions should be assessed independently

A REDCap-based model for electronic consent (eConsent): Moving toward a more personalized consent

Introduction: The updated common rule, for human subjects research, requires that consents begin with a \u27concise and focused\u27 presentation of the key information that will most likely help someone make a decision about whether to participate in a study (Menikoff, Kaneshiro, Pritchard. The New England Journal of Medicine. 2017; 376(7): 613-615.). We utilized a community-engaged technology development approach to inform feature options within the REDCap software platform centered around collection and storage of electronic consent (eConsent) to address issues of transparency, clinical trial efficiency, and regulatory compliance for informed consent (Harris, et al. Journal of Biomedical Informatics 2009; 42(2): 377-381.). eConsent may also improve recruitment and retention in clinical research studies by addressing: (1) barriers for accessing rural populations by facilitating remote consent and (2) cultural and literacy barriers by including optional explanatory material (e.g., defining terms by hovering over them with the cursor) or the choice of displaying different videos/images based on participant\u27s race, ethnicity, or educational level (Phillippi, et al. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2018; 47(4): 529-534.). Methods: We developed and pilot tested our eConsent framework to provide a personalized consent experience whereby users are guided through a consent document that utilizes avatars, contextual glossary information supplements, and videos, to facilitate communication of information. Results: The eConsent framework includes a portfolio of eight features, reviewed by community stakeholders, and tested at two academic medical centers. Conclusions: Early adoption and utilization of this eConsent framework have demonstrated acceptability. Next steps will emphasize testing efficacy of features to improve participant engagement with the consent process