Examining Faith Community Nurses’ Perception and Utilization of Electronic Health Records

Abstract The purpose of this study is to identify current faith community nurse documentation practices, explore factors impacting intention to adopt electronic health records, and identify perceived barriers and benefits to electronic health record use among faith community nurses practicing in the Midwest. The technology acceptance model is used to examine impact of perceived usefulness and perceived ease of use of electronic health records on intention to adopt. This study is a quantitative exploratory research study utilizing a cross-sectional researcher-developed 39-item questionnaire. Surveys were distributed by mail and e-mail to faith community nurses practicing in South-Central Indiana and Western Kentucky. Survey data was collected from 114 faith community nurses whose nursing educational levels ranged from diploma to PhD for a response rate of 46%. Descriptive statistics and Pearson’s correlations were used to report study results. Positive correlations were found between both perceived usefulness and perceived ease of use and intention to adopt with a stronger correlation associated with perceived usefulness. Participants reported financial challenges as most significant barriers to electronic health record adoption while the highest rated benefits were associated with record access, enhanced care coordination, and improved ability to identify and communicate FCN practice to decision makers. This study adds new knowledge on documentation practices and perceptions of faith community nurses related to electronic health records. Understanding the impact of perceived usefulness, ease of use, barriers, and benefits on electronic health record adoption will inform future initiatives seeking to increase faith community nurse electronic health record adoption. Keywords: faith community nurses, electronic health record, adoption, barriers, facilitator

A Colorectal Cancer Screening Project in an Old Order Mennonite Community: Capstone Project Technical Report

The purpose of this project was to determine if colorectal cancer (CRC) screening education and community access to fecal occult blood tests (FOBT) is associated with an increase in the uptake of FOBT in an old order Mennonite community. Utilizing a modified cultural model, an educational offering on CRC screening and access to FOBT in the community was delivered to a self-selected sample of age-eligible participants. Thirty-three age eligible residents completed the CRC screening questionnaires and received education on CRC screening. Twenty-nine of the age-eligible participants were found to be at average risk and twenty-three elected to receive FOBT testing kits. The most commonly reported previous CRC screening was colonoscopy; however, only 30% of the population had completed any previous CRC screening. This project was successful in increasing the uptake of FOBT in an old order Mennonite community through the provision of culturally appropriate education and the delivery of FOBT within the community using a modified cultural model. If the high FOBT uptake is maintained in other OOM/Amish populations FOBT is a viable CRC screening tool in these populations

Child Weight and Feeding Patterns in an Old Order Mennonite Community

Purpose: Feeding practices in some religious communities may decrease childhood obesity. However, there is limited research in these communities to assess maternal perceptions of their children's weight and feeding patterns. The purpose of this study was to ascertain Old Order Mennonite mothers' perceptions of their children's body weight and to examine feeding patterns for their children. Sample: Participants for this descriptive, correlational study were recruited from an Old Order Mennonite community in south central Kentucky. Sampling was achieved using a snowball sampling strategy and the use of a community insider. Methods: Body Mass Index was measured for mothers and child participants, and mothers completed four questionnaires. Fourteen families with 65 children participated. Findings: Fifteen children (23.1%) had BMIs > 85%, and weight was underestimated in 24.6% of children. Breastfeeding was common (98.5%), with a mean age for cessation of 17.3 months. Mean age for introduction of solid foods was eight months. Results from the CFQ demonstrated mothers were neutral about obesity risk in their child (X=3.05). Mothers reported concerns about high sugar foods, limiting access to unhealthy foods, and children eating all food served at meals. Maternal health literacy scores (X=33.98) were comparable to scores found in other studies. A lower PSOC score (X=23.36) was found. Conclusions: Further study needs to be conducted in this community to ascertain specific feeding habits that may account for increased BMIs

Child Weight and Feeding Patterns in an Old Order Mennonite Community

Purpose: Feeding practices in some religious communities may decrease childhood obesity. However, there is limited research in these communities to assess maternal perceptions of their children’s weight and feeding patterns. The purpose of this study was to ascertain Old Order Mennonite mothers’ perceptions of their children’s body weight and to examine feeding patterns for their children. Sample: Participants for this descriptive, correlational study were recruited from an Old Order Mennonite community in south central Kentucky. Sampling was achieved using a snowball sampling strategy and the use of a community insider. Methods: Body Mass Index was measured for mothers and child participants, and mothers completed four questionnaires. Fourteen families with 65 children participated. Findings: Fifteen children (23.1%) had BMIs \u3e 85%, and weight was underestimated in 24.6% of children. Breastfeeding was common (98.5%), with a mean age for cessation of 17.3 months. Mean age for introduction of solid foods was eight months. Results from the CFQ demonstrated mothers were neutral about obesity risk in their child (X=3.05). Mothers reported concerns about high sugar foods, limiting access to unhealthy foods, and children eating all food served at meals. Maternal health literacy scores (X=33.98) were comparable to scores found in other studies. A lower PSOC score (X= 23.36) was found. Conclusions: Further study needs to be conducted in this community to ascertain specific feeding habits that may account for increased BMIs

Anabaptist Community Members\u27 Perceptions and Preferences Related to Healthcare

The plain Anabaptists are thought to differ from mainstream U.S. health care beliefs and practices. Many non-Anabaptist health care providers have limited knowledge of the specific health beliefs and preferences of Anabaptists, which can lead to misunderstandings. The purpose of this descriptive qualitative study was to collect information from Anabaptist community members related to health care beliefs and preferences in their communities. Participants, who were members of various plain Anabaptist communities, completed a questionnaire containing open-ended questions about health issues. Seven themes emerged in results: (1) health viewed as a gift from God that provides the ability to work; (2) concern about exposure to chemicals and food additives as health risks; (3) the use of a variety of resources from lay members in the community in addition to seeking information from professionals; (4) the desire to use natural remedies first with outside care being sought when deemed necessary; (5) barriers to seeking professional healthcare were mainly related to cost, time, and provider attitudes; (6) maintenance of a good diet, being active and having good dental care were important preventative activities; and (7) expectation of respect, engagement and caring from providers

Kentucky Anabaptists' Knowledge of Newborn Screening

The Plain Anabaptist population in Kentucky is growing, with the Amish population alone expected to double about every 20 years. Anabaptists in Kentucky are largely composed of Amish (both Old Order and New Order) and Old Order and Conservative Mennonites. All Anabaptists experience an increased incidence of recessive genetic disorders. Newborn screening (NBS) is a state-regulated program that identifies inherited and congenital disorders and conditions. The purpose of this study is to determine the knowledge of Kentucky Amish and Mennonite communities regarding NBS. A researcher-adapted questionnaire was mailed to Kentucky Amish and Mennonite households, and 292 respondents returned the questionnaire. The majority (85.2%) reported at least "a little" knowledge of NBS; however, only 6.8% reported "a lot" of knowledge. Respondents identified the midwife as the most common source of information related to NBS; however, 18% reported NBS was not offered by any provider. There was a statistically significant relationship between knowledge of NBS and children receiving NBS, indicating that knowledge of NBS increased participation in NBS. As the midwife is the most common source of NBS knowledge, an educational program for midwives as well as the Anabaptist communities throughout Kentucky is planned

A Pilot Study: Using the Health Belief Model to Understand Cannabidiol Use in One Amish Community

Amish use of complementary and alternative medicine is common, but little is known about their opinion of cannabidiol. Hemp legalization has popularized cannabidiol, making it available to Amish whose traditions limit access to scientific information. The purpose of this pilot study is to gain an understanding of cannabidiol use in one Old Order Amish community. A researcher-developed questionnaire was mailed to 60 members of one Amish district. The Medicinal Cannabidiol Survey for an Amish Population was adapted from the Medicinal Cannabis Survey for General Practitioners to the specification of cannabidiol, Amish cultural relevance, and the six theoretical constructs of the health belief model. A content validity survey was completed with an overall item-level content validity index score of .92. Most respondents reported hearing discussions in the Amish community regarding cannabidiol [81.8% (n = 9)]. Slightly more agreement was found within the 10 benefit construct statements (40%) compared to six barrier statements (36.5%). Low agreement was observed among all nine questionnaire statements addressing Amish perceived threat to using cannabidiol. The barrier statement that cannabidiol cost prohibits its use had the highest agreement [90.9% (n = 10)] among all statements, which may be a stronger barrier when considering Amish culture. Higher agreement among the benefit construct compared to lower agreement among statements surrounding Amish perceived threat of cannabidiol suggests the likelihood of their cannabidiol use. A major limitation of this study was the sample size; therefore, the tool should be used in a large Amish sample to explore the findings of this pilot study.