Implementing Faith Community Nursing Interventions to Promote Healthy Behaviors in Adults

Purpose: To report the implementation of faith community nursing interventions to promote healthy behaviors in adults. Callaghan (2015) reported the development of this intervention, which was based on previous studies that support the importance of spiritual growth on the initiative and responsibility for self-care across the life span (Callaghan, 2003, 2005, 2006). The intervention also included strategies to increase self-efficacy of healthy behaviors. The results of three separate implementations of the health promotion intervention are presented in this report. Procedures: Three health promotion programs were implemented over a five year period (2010 – 2015). These programs were offered for the following populations/settings: families consisting of adolescents, adults, and/or older adults in a faith community; nursing students in a university community; older adults in an urban community. The outcomes of the programs were measured by the Health-Promoting Lifestyle Profile II (HPLPII) scale using paired t-Tests to test the hypothesis that post-intervention scores would be higher than the pre-intervention scores. Findings: The mean scores of participants in the health promotion programs all increased from pre-intervention to post-intervention. Significant differences were found in the nursing student and the older adult samples. Conclusions: The results of these studies suggest that faith community nursing-led health promotion interventions that focus on spiritual growth as the foundation of health as well as use self-efficacy enhancing strategies can increase participants’ practice of healthy behaviors. These programs also give faith community nurses an opportunity to expand practice beyond the walls of their faith communities

The Development of a Faith Community Nursing Intervention to Promote Health across the Life Span

Purpose: To report the development of a faith community nursing intervention to promote health across the life span. Studies by Callaghan (2003, 2005, 2006), that investigated the relationships among self-care agency, self-care self-efficacy, and health-promoting self-care behaviors, support the importance of spiritual growth on older adults’, adults’, and adolescents’ initiative and responsibility for self-care. This report will focus on applying these results and the research evidence that supports the integration of these concepts in the development of a health promotion intervention. Procedures: Data was merged from Callaghan’s studies (2003, 2005, 2006) in order to investigate to what extent do self-care agency and self-care self-efficacy explain health-promoting self-care behaviors across the life span. The sample consisted of 870 subjects with ages ranging from 14 to 98 years. The instrumentation included the following scales: Exercise of Self-Care Agency, Self-Rated Abilities for Health Practices, Health-Promoting Lifestyle Profile II, demographic questionnaire. The data was analyzed using a canonical correlation statistic. Findings: A significant canonical variate with a canonical correlation of .81 (p \u3c .001) accounting for 65% of the variance explained was identified. The canonical loadings identified all of the study variables as significantly contributing to this variate. Conclusions: The study results support the integration of the concepts of self-care agency, self-care self-efficacy, and health-promoting self-care behaviors in the development of a faith community nursing intervention to promote health across the life span. The development of an intervention based on this evidence is presented

Basic Conditioning Factors' Influences on Adolescents' Healthy Behaviors, Self-Efficacy, and Self-Care

This article reports a secondary statistical analysis of data from a study investigating the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an adolescent population (Callaghan, 2005). The purpose of this study was to identify the influences of selected basic conditioning factors on the practice of healthy behaviors, self-efficacy beliefs, and ability for self-care in 256 adolescents. The research instruments used to collect data for this study include: Health-Promoting Lifestyle Profile II Scale; Self-Rated Abilities for Health Practices Scale; Exercise of Self-Care Agency Scale; demographic questionnaire assessing basic conditioning factors. The results of this analysis identified significant relationships between the following basic conditioning factors and adolescents' practice of healthy behaviors, self-efficacy of those behaviors, and self-care abilities: support system, adequate income, adequate living conditions, gender, routine practice of religion, and reported medical problems/disabilities. These findings can give adolescent health nurses direction in developing interventions that promote the self-care and health in this specific population

The impact of advertising patient and public involvement on trial recruitment: embedded cluster randomised recruitment trial

BACKGROUND Patient and public involvement in research (PPIR) may improve trial recruitment rates, but it is unclear how. Where trials use PPIR to improve design and conduct, many do not communicate that clearly to potential participants. Better communication of PPIR might encourage patient enrolment, as trials may be perceived as more socially valid, relevant, and trustworthy. We aimed to evaluate the impact on recruitment of directly advertising PPIR to potential trial participants. METHODS A cluster trial, embedded within a host trial ('EQUIP') recruiting service users diagnosed with severe mental illness. The intervention was informed by a systematic review, a qualitative study, social comparison theory and a stakeholder workshop including service users and carers. Adopting Participatory Design approaches, we co-designed the recruitment intervention with PPIR partners using a leaflet to advertise the PPIR in EQUIP and sent potential participants invitations with the leaflet (intervention group) or not (control group). Primary outcome was the proportion of patients enrolled in EQUIP. Secondary outcomes included the proportions of patients who positively responded to the trial invitation. RESULTS 34 community mental health teams were randomised and 8182 service users invited. For the primary outcome, 4% of patients in the PPIR group were enrolled versus 5.3% of the control group. The intervention was ineffective for improving recruitment rates (adjusted OR= 0.75, 95% CI= 0.53 to 1.07, p=0.113). For the secondary outcome of positive response, the intervention was not effective, with 7.3% of potential participants in the intervention group responding positively versus 7.9% of the control group (adjusted OR=0.74, 95% CI= 0.53 to 1.04, p=0.082). We did not find a positive impact of directly advertising PPIR on any other outcomes. CONCLUSION To our knowledge, this is the largest ever embedded trial to evaluate a recruitment or PPIR intervention. Advertising PPIR did not improve enrolment rates, or any other outcome. It is possible that rather than advertising PPIR being the means to improve recruitment, PPIR may have an alternative impact on trials by making them more attractive, acceptable and patient-centred. We discuss potential reasons for our findings and implications for recruitment practice and research

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Exploration and Description of Faith Community Nurses’ Documentation Practices and Perceived Documentation Barriers.

Purpose: Documentation within Faith Community Nursing is an expected aspect of the professional specialty but is under-studied. Findings in previously published studies suggest there is a lack of consistent documentation practices among FCNs. Therefore, the aim of this research study was to explore and describe documentation practices of FCNs, and identify the perceived barriers to documentation. Methodology: This mixed methods research had both qualitative and quantitative components. The qualitative inquiry involved three live focus groups and three telephonic key informant interviews (n = 28). Conventional content analysis was used to examine all qualitative data. The quantitative inquiry involved a survey that was developed to capture the objective data related to FCNs’ demographic characteristics as well as documentation practices (n = 153). Findings: The qualitative findings reveal that FCNs engage in the professional mandate for documentation but lack clarity for autonomous practice and nursing process expectations. The nurses attempt to capture the fullness of specialty encounters but lack supportive infrastructure and interprofessional communication. The quantitative findings indicated these nurses are a highly-educated group with bachelors and masters level education who document at least sometimes using a variety of approaches. Most had computer skills and most would use a smart phone or table application to document if appropriate software was developed specifically for FCNs. Conclusion: Even though FCNs are aware of their documentation responsibilities, they still are not consistently documenting. The documentation largely is focused on quantity and not quality of interactions. The streamlining, standardizing, and sharing of FCN documentation could support healthcare transformation as well as provide evidence of FCN practice outcomes

Enacting a framework for community development: Engagement and outcomes for students and faculty co-researchers

Healthy community development in cities, workplaces and educational settings has been the focus of considerable research, policy and practice activity. Healthy community development emphasizes changing health determinants. While the theory is appealing, engaging community members to translate theory into action is challenging. This paper outlines a framework for healthy community development which brings together cross-sector community members to change health determinants. Use of the VOICE framework in a long term project with a university campus is described. In the project, campus community members work as co-researchers to assess the health of the community, identify priority issues, mobilize existing resources, and create health-promoting change. Project achievements have included improvements in campus community health and increases in research and healthy community development capacity of all types of co-researchers. This paper focuses on the engagement of students and faculty as co-researchers and outcomes for each group from participation. Outcomes for non-academic co-researchers (other community members) are briefly described. Related literature on community service learning and undergraduate student researchers is reviewed. Other campuses and communities can easily adapt the VOICE framework and engagement strategies to change health determinants in their settings.Other UBCHealth and Social Development, Faculty of (Okanagan)Nursing, School of (Okanagan)Arts and Sciences, Irving K. Barber School of (Okanagan)Biology, Department of (Okanagan)ReviewedFacultyOtherUndergraduat